National Provider Identifier [NPI]: |
1073503462 |
Last Name Of The Provider |
PHILLIPS |
First Name Of The Provider |
ALFRED |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
925 IRONWOOD DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MINDEN |
Zip Code Of The Provider |
894235178 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
752 |
Number Of Medicare Beneficiaries |
602 |
Total Submitted Charge Amount |
194275 |
Total Medicare Allowed Amount |
61151.34 |
Total Medicare Payment Amount |
45120.72 |
Total Medicare Standardized Payment Amount |
43894.9 |
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 |
32 |
Number Of Medical Services |
752 |
Number Of Medicare Beneficiaries With Medical Services |
602 |
Total Medical Submitted Charge Amount |
194275 |
Total Medical Medicare Allowed Amount |
61151.34 |
Total Medical Medicare Payment Amount |
45120.72 |
Total Medical Medicare Standardized Payment Amount |
43894.9 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
284 |
Number Of Beneficiaries Age 75 to 84 |
170 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
365 |
Number Of Male Beneficiaries |
237 |
Number Of Non Hispanic White Beneficiaries |
566 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
550 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0039 |