| National Provider Identifier [NPI]: | 1043288756 |
| Last Name Of The Provider | PHIPPS |
| First Name Of The Provider | JERALD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 504 N CLEVELAND ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MOUNT AYR |
| Zip Code Of The Provider | 508542201 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 611 |
| Number Of Medicare Beneficiaries | 183 |
| Total Submitted Charge Amount | 49155 |
| Total Medicare Allowed Amount | 36339.66 |
| Total Medicare Payment Amount | 26816.18 |
| Total Medicare Standardized Payment Amount | 28853.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 59 |
| Number Of Medicare Beneficiaries With Drug Services | 59 |
| Total Drug Submitted ChargeAmount | 1475 |
| Total Drug Medicare AllowedAmount | 824 |
| Total Drug Medicare PaymentAmount | 807.64 |
| Total Drug Medicare Standardized Payment Amount | 807.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 552 |
| Number Of Medicare Beneficiaries With Medical Services | 183 |
| Total Medical Submitted Charge Amount | 47680 |
| Total Medical Medicare Allowed Amount | 35515.66 |
| Total Medical Medicare Payment Amount | 26008.54 |
| Total Medical Medicare Standardized Payment Amount | 28045.9 |
| Average Age Of Beneficiaries | 83 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | 58 |
| Number Of Beneficiaries Age Greater 84 | 89 |
| Number Of Female Beneficiaries | 119 |
| Number Of Male Beneficiaries | 64 |
| 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 | 98 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 54 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 66 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4858 |