| National Provider Identifier [NPI]: | 1447259643 |
| Last Name Of The Provider | RAY |
| First Name Of The Provider | SHELLEY |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1419 HAMRIC DR E |
| Street Address 2 Of The Provider | #101 |
| City Of The Provider | OXFORD |
| Zip Code Of The Provider | 362031933 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 7201 |
| Number Of Medicare Beneficiaries | 1074 |
| Total Submitted Charge Amount | 662006 |
| Total Medicare Allowed Amount | 489123.9 |
| Total Medicare Payment Amount | 359550 |
| Total Medicare Standardized Payment Amount | 392202.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 249 |
| Number Of Medicare Beneficiaries With Drug Services | 102 |
| Total Drug Submitted ChargeAmount | 66335 |
| Total Drug Medicare AllowedAmount | 54452.49 |
| Total Drug Medicare PaymentAmount | 42232.75 |
| Total Drug Medicare Standardized Payment Amount | 42232.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 6952 |
| Number Of Medicare Beneficiaries With Medical Services | 1074 |
| Total Medical Submitted Charge Amount | 595671 |
| Total Medical Medicare Allowed Amount | 434671.41 |
| Total Medical Medicare Payment Amount | 317317.25 |
| Total Medical Medicare Standardized Payment Amount | 349969.43 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 92 |
| Number Of Beneficiaries Age 65 to 74 | 534 |
| Number Of Beneficiaries Age 75 to 84 | 345 |
| Number Of Beneficiaries Age Greater 84 | 103 |
| Number Of Female Beneficiaries | 587 |
| Number Of Male Beneficiaries | 487 |
| Number Of Non Hispanic White Beneficiaries | 1032 |
| Number Of Black or African American Beneficiaries | 22 |
| 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 | 1024 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 50 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.028 |