| National Provider Identifier [NPI]: | 1548250608 |
| Last Name Of The Provider | PHILLIPS |
| First Name Of The Provider | CAROL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | ARNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6128 S TAMIAMI TRL |
| Street Address 2 Of The Provider | |
| City Of The Provider | SARASOTA |
| Zip Code Of The Provider | 342314029 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 726 |
| Number Of Medicare Beneficiaries | 428 |
| Total Submitted Charge Amount | 79759 |
| Total Medicare Allowed Amount | 43000.69 |
| Total Medicare Payment Amount | 28796.13 |
| Total Medicare Standardized Payment Amount | 35312.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 13 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 652 |
| Total Drug Medicare AllowedAmount | 384.98 |
| Total Drug Medicare PaymentAmount | 341.82 |
| Total Drug Medicare Standardized Payment Amount | 341.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 713 |
| Number Of Medicare Beneficiaries With Medical Services | 428 |
| Total Medical Submitted Charge Amount | 79107 |
| Total Medical Medicare Allowed Amount | 42615.71 |
| Total Medical Medicare Payment Amount | 28454.31 |
| Total Medical Medicare Standardized Payment Amount | 34971.05 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 181 |
| Number Of Beneficiaries Age 75 to 84 | 139 |
| Number Of Beneficiaries Age Greater 84 | 70 |
| Number Of Female Beneficiaries | 286 |
| Number Of Male Beneficiaries | 142 |
| Number Of Non Hispanic White Beneficiaries | 411 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 392 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9499 |