| National Provider Identifier [NPI]: | 1427176429 |
| Last Name Of The Provider | SHIRLEY |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9958 PENINSULA DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | TRAVERSE CITY |
| Zip Code Of The Provider | 496868395 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 196 |
| Number Of Services | 7339 |
| Number Of Medicare Beneficiaries | 5124 |
| Total Submitted Charge Amount | 595501 |
| Total Medicare Allowed Amount | 209462.25 |
| Total Medicare Payment Amount | 154286.59 |
| Total Medicare Standardized Payment Amount | 159391.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 196 |
| Number Of Medical Services | 7339 |
| Number Of Medicare Beneficiaries With Medical Services | 5124 |
| Total Medical Submitted Charge Amount | 595501 |
| Total Medical Medicare Allowed Amount | 209462.25 |
| Total Medical Medicare Payment Amount | 154286.59 |
| Total Medical Medicare Standardized Payment Amount | 159391.57 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 1049 |
| Number Of Beneficiaries Age 65 to 74 | 1792 |
| Number Of Beneficiaries Age 75 to 84 | 1479 |
| Number Of Beneficiaries Age Greater 84 | 804 |
| Number Of Female Beneficiaries | 2932 |
| Number Of Male Beneficiaries | 2192 |
| Number Of Non Hispanic White Beneficiaries | 4977 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | 50 |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3696 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1428 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4848 |