| National Provider Identifier [NPI]: | 1306846084 |
| Last Name Of The Provider | SHIPMAN |
| First Name Of The Provider | NOLAN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3201 UNIVERSITY DR E |
| Street Address 2 Of The Provider | SUITE 375 |
| City Of The Provider | BRYAN |
| Zip Code Of The Provider | 778023485 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 4730 |
| Number Of Medicare Beneficiaries | 543 |
| Total Submitted Charge Amount | 335474 |
| Total Medicare Allowed Amount | 154576.76 |
| Total Medicare Payment Amount | 105461.16 |
| Total Medicare Standardized Payment Amount | 112607.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 127 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 4635 |
| Total Drug Medicare AllowedAmount | 447.04 |
| Total Drug Medicare PaymentAmount | 287.47 |
| Total Drug Medicare Standardized Payment Amount | 287.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 4603 |
| Number Of Medicare Beneficiaries With Medical Services | 543 |
| Total Medical Submitted Charge Amount | 330839 |
| Total Medical Medicare Allowed Amount | 154129.72 |
| Total Medical Medicare Payment Amount | 105173.69 |
| Total Medical Medicare Standardized Payment Amount | 112319.88 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 235 |
| Number Of Beneficiaries Age 75 to 84 | 181 |
| Number Of Beneficiaries Age Greater 84 | 83 |
| Number Of Female Beneficiaries | 304 |
| Number Of Male Beneficiaries | 239 |
| Number Of Non Hispanic White Beneficiaries | 479 |
| Number Of Black or African American Beneficiaries | 30 |
| 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 | 487 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0042 |