| National Provider Identifier [NPI]: | 1952302556 |
| Last Name Of The Provider | SHIELDS |
| First Name Of The Provider | MOLLY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1661 SOQUEL DR |
| Street Address 2 Of The Provider | BUILDING E |
| City Of The Provider | SANTA CRUZ |
| Zip Code Of The Provider | 950651709 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 6281 |
| Number Of Medicare Beneficiaries | 923 |
| Total Submitted Charge Amount | 668796.17 |
| Total Medicare Allowed Amount | 355986.19 |
| Total Medicare Payment Amount | 260777.59 |
| Total Medicare Standardized Payment Amount | 246059.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 88 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 6150 |
| Total Drug Medicare AllowedAmount | 4765.29 |
| Total Drug Medicare PaymentAmount | 3723.13 |
| Total Drug Medicare Standardized Payment Amount | 3723.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 6193 |
| Number Of Medicare Beneficiaries With Medical Services | 923 |
| Total Medical Submitted Charge Amount | 662646.17 |
| Total Medical Medicare Allowed Amount | 351220.9 |
| Total Medical Medicare Payment Amount | 257054.46 |
| Total Medical Medicare Standardized Payment Amount | 242336.8 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 68 |
| Number Of Beneficiaries Age 65 to 74 | 516 |
| Number Of Beneficiaries Age 75 to 84 | 242 |
| Number Of Beneficiaries Age Greater 84 | 97 |
| Number Of Female Beneficiaries | 677 |
| Number Of Male Beneficiaries | 246 |
| Number Of Non Hispanic White Beneficiaries | 869 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 832 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 91 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 13 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 1 |
| Average HCC Risk Score Of Beneficiaries | 0.8499 |