National Provider Identifier [NPI]: |
1538380415 |
Last Name Of The Provider |
PHILLIPS |
First Name Of The Provider |
HANNAH |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
21785 FILIGREE CT |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
ASHBURN |
Zip Code Of The Provider |
201476213 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
79 |
Number Of Services |
1764 |
Number Of Medicare Beneficiaries |
225 |
Total Submitted Charge Amount |
119465 |
Total Medicare Allowed Amount |
64732.02 |
Total Medicare Payment Amount |
49197.64 |
Total Medicare Standardized Payment Amount |
51881.08 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
79 |
Number Of Medicare Beneficiaries With Drug Services |
65 |
Total Drug Submitted ChargeAmount |
4122 |
Total Drug Medicare AllowedAmount |
2291.4 |
Total Drug Medicare PaymentAmount |
2237.07 |
Total Drug Medicare Standardized Payment Amount |
2237.07 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
68 |
Number Of Medical Services |
1685 |
Number Of Medicare Beneficiaries With Medical Services |
224 |
Total Medical Submitted Charge Amount |
115343 |
Total Medical Medicare Allowed Amount |
62440.62 |
Total Medical Medicare Payment Amount |
46960.57 |
Total Medical Medicare Standardized Payment Amount |
49644.01 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
119 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
176 |
Number Of Male Beneficiaries |
49 |
Number Of Non Hispanic White Beneficiaries |
187 |
Number Of Black or African American Beneficiaries |
24 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
202 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
51 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8087 |