| National Provider Identifier [NPI]: | 1922039551 |
| Last Name Of The Provider | ROSS |
| First Name Of The Provider | PHILLIP |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 445 CLIFTY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MADISON |
| Zip Code Of The Provider | 472501607 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 2111 |
| Number Of Medicare Beneficiaries | 371 |
| Total Submitted Charge Amount | 261252.34 |
| Total Medicare Allowed Amount | 115533.86 |
| Total Medicare Payment Amount | 80420.31 |
| Total Medicare Standardized Payment Amount | 86425.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 327 |
| Number Of Medicare Beneficiaries With Drug Services | 151 |
| Total Drug Submitted ChargeAmount | 18654 |
| Total Drug Medicare AllowedAmount | 9216.88 |
| Total Drug Medicare PaymentAmount | 8638.1 |
| Total Drug Medicare Standardized Payment Amount | 8638.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 1784 |
| Number Of Medicare Beneficiaries With Medical Services | 371 |
| Total Medical Submitted Charge Amount | 242598.34 |
| Total Medical Medicare Allowed Amount | 106316.98 |
| Total Medical Medicare Payment Amount | 71782.21 |
| Total Medical Medicare Standardized Payment Amount | 77787.83 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 166 |
| Number Of Beneficiaries Age 75 to 84 | 100 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 198 |
| Number Of Male Beneficiaries | 173 |
| Number Of Non Hispanic White Beneficiaries | 357 |
| Number Of Black or African American Beneficiaries | |
| 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 | 303 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 68 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9316 |