| National Provider Identifier [NPI]: | 1801865993 |
| Last Name Of The Provider | SHIPTON |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 E UNION ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | POTTSVILLE |
| Zip Code Of The Provider | 179013519 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 61 |
| Number Of Services | 3430 |
| Number Of Medicare Beneficiaries | 802 |
| Total Submitted Charge Amount | 388972 |
| Total Medicare Allowed Amount | 175756.25 |
| Total Medicare Payment Amount | 127567.42 |
| Total Medicare Standardized Payment Amount | 133055.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1440 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 128530 |
| Total Drug Medicare AllowedAmount | 42590.58 |
| Total Drug Medicare PaymentAmount | 32771.99 |
| Total Drug Medicare Standardized Payment Amount | 32771.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 1990 |
| Number Of Medicare Beneficiaries With Medical Services | 802 |
| Total Medical Submitted Charge Amount | 260442 |
| Total Medical Medicare Allowed Amount | 133165.67 |
| Total Medical Medicare Payment Amount | 94795.43 |
| Total Medical Medicare Standardized Payment Amount | 100283.42 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 292 |
| Number Of Beneficiaries Age 75 to 84 | 300 |
| Number Of Beneficiaries Age Greater 84 | 146 |
| Number Of Female Beneficiaries | 164 |
| Number Of Male Beneficiaries | 638 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 705 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 97 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2215 |