| National Provider Identifier [NPI]: | 1396740882 |
| Last Name Of The Provider | PHILLIPS |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2024 15TH ST FL 2 |
| Street Address 2 Of The Provider | |
| City Of The Provider | MERIDIAN |
| Zip Code Of The Provider | 393014130 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 166 |
| Number Of Services | 9595 |
| Number Of Medicare Beneficiaries | 1604 |
| Total Submitted Charge Amount | 1083046.59 |
| Total Medicare Allowed Amount | 418900.04 |
| Total Medicare Payment Amount | 311859.39 |
| Total Medicare Standardized Payment Amount | 334958.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 593 |
| Number Of Medicare Beneficiaries With Drug Services | 291 |
| Total Drug Submitted ChargeAmount | 10673.96 |
| Total Drug Medicare AllowedAmount | 10621.64 |
| Total Drug Medicare PaymentAmount | 10093.51 |
| Total Drug Medicare Standardized Payment Amount | 10093.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 151 |
| Number Of Medical Services | 9002 |
| Number Of Medicare Beneficiaries With Medical Services | 1604 |
| Total Medical Submitted Charge Amount | 1072372.63 |
| Total Medical Medicare Allowed Amount | 408278.4 |
| Total Medical Medicare Payment Amount | 301765.88 |
| Total Medical Medicare Standardized Payment Amount | 324865.01 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 279 |
| Number Of Beneficiaries Age 65 to 74 | 558 |
| Number Of Beneficiaries Age 75 to 84 | 492 |
| Number Of Beneficiaries Age Greater 84 | 275 |
| Number Of Female Beneficiaries | 942 |
| Number Of Male Beneficiaries | 662 |
| Number Of Non Hispanic White Beneficiaries | 1194 |
| Number Of Black or African American Beneficiaries | 388 |
| 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 | 1139 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 465 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5206 |