| National Provider Identifier [NPI]: | 1609846906 |
| Last Name Of The Provider | GASKILL-SHIPLEY |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 234 GOODMAN ST |
| Street Address 2 Of The Provider | DEPARTMENT OF RADIOLOGY |
| City Of The Provider | CINCINNATI |
| Zip Code Of The Provider | 452671000 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 3243 |
| Number Of Medicare Beneficiaries | 890 |
| Total Submitted Charge Amount | 577896.5 |
| Total Medicare Allowed Amount | 130322.79 |
| Total Medicare Payment Amount | 99468.42 |
| Total Medicare Standardized Payment Amount | 108195.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1975 |
| Number Of Medicare Beneficiaries With Drug Services | 83 |
| Total Drug Submitted ChargeAmount | 9112.5 |
| Total Drug Medicare AllowedAmount | 1080.53 |
| Total Drug Medicare PaymentAmount | 816.15 |
| Total Drug Medicare Standardized Payment Amount | 816.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 1268 |
| Number Of Medicare Beneficiaries With Medical Services | 890 |
| Total Medical Submitted Charge Amount | 568784 |
| Total Medical Medicare Allowed Amount | 129242.26 |
| Total Medical Medicare Payment Amount | 98652.27 |
| Total Medical Medicare Standardized Payment Amount | 107379.58 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 315 |
| Number Of Beneficiaries Age 65 to 74 | 307 |
| Number Of Beneficiaries Age 75 to 84 | 194 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 492 |
| Number Of Male Beneficiaries | 398 |
| Number Of Non Hispanic White Beneficiaries | 670 |
| Number Of Black or African American Beneficiaries | 204 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 557 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 333 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 25 |
| Average HCC Risk Score Of Beneficiaries | 1.8958 |