National Provider Identifier [NPI]: |
1801869706 |
Last Name Of The Provider |
PHILLIPS |
First Name Of The Provider |
LYNN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
64 ROBBINS ST |
Street Address 2 Of The Provider |
SIXTH FLOOR |
City Of The Provider |
WATERBURY |
Zip Code Of The Provider |
067082613 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
998 |
Number Of Medicare Beneficiaries |
405 |
Total Submitted Charge Amount |
225822 |
Total Medicare Allowed Amount |
116399.22 |
Total Medicare Payment Amount |
90217.04 |
Total Medicare Standardized Payment Amount |
86491 |
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 |
16 |
Number Of Medical Services |
998 |
Number Of Medicare Beneficiaries With Medical Services |
405 |
Total Medical Submitted Charge Amount |
225822 |
Total Medical Medicare Allowed Amount |
116399.22 |
Total Medical Medicare Payment Amount |
90217.04 |
Total Medical Medicare Standardized Payment Amount |
86491 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
64 |
Number Of Beneficiaries Age 75 to 84 |
128 |
Number Of Beneficiaries Age Greater 84 |
157 |
Number Of Female Beneficiaries |
225 |
Number Of Male Beneficiaries |
180 |
Number Of Non Hispanic White Beneficiaries |
316 |
Number Of Black or African American Beneficiaries |
59 |
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 |
221 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
184 |
Percent Of With Atrial Fibrillation |
40 |
Percent Of With Alzheimers Disease or Dementia |
43 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
64 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.5538 |