National Provider Identifier [NPI]: |
1063724987 |
Last Name Of The Provider |
SHIPP |
First Name Of The Provider |
LYNDSAY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2500 N STATE ST |
Street Address 2 Of The Provider |
DEPARTMENT OF MEDICINE |
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
392164500 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
1512 |
Number Of Medicare Beneficiaries |
408 |
Total Submitted Charge Amount |
107656 |
Total Medicare Allowed Amount |
65122.79 |
Total Medicare Payment Amount |
50377.24 |
Total Medicare Standardized Payment Amount |
54197.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
355 |
Number Of Medicare Beneficiaries With Drug Services |
37 |
Total Drug Submitted ChargeAmount |
1086 |
Total Drug Medicare AllowedAmount |
639.09 |
Total Drug Medicare PaymentAmount |
484.43 |
Total Drug Medicare Standardized Payment Amount |
484.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
1157 |
Number Of Medicare Beneficiaries With Medical Services |
407 |
Total Medical Submitted Charge Amount |
106570 |
Total Medical Medicare Allowed Amount |
64483.7 |
Total Medical Medicare Payment Amount |
49892.81 |
Total Medical Medicare Standardized Payment Amount |
53713.04 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
221 |
Number Of Beneficiaries Age 75 to 84 |
101 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
236 |
Number Of Male Beneficiaries |
172 |
Number Of Non Hispanic White Beneficiaries |
369 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
325 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
83 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9516 |