| National Provider Identifier [NPI]: | 1952414120 |
| Last Name Of The Provider | PHILIP |
| First Name Of The Provider | ANNIE |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 601 ELMWOOD AVE |
| Street Address 2 Of The Provider | BOX 604 |
| City Of The Provider | ROCHESTER |
| Zip Code Of The Provider | 146420001 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 690 |
| Number Of Medicare Beneficiaries | 255 |
| Total Submitted Charge Amount | 184409 |
| Total Medicare Allowed Amount | 47259.95 |
| Total Medicare Payment Amount | 34890.61 |
| Total Medicare Standardized Payment Amount | 35861.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 41 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 164 |
| Total Drug Medicare AllowedAmount | 134.18 |
| Total Drug Medicare PaymentAmount | 105.08 |
| Total Drug Medicare Standardized Payment Amount | 105.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 649 |
| Number Of Medicare Beneficiaries With Medical Services | 255 |
| Total Medical Submitted Charge Amount | 184245 |
| Total Medical Medicare Allowed Amount | 47125.77 |
| Total Medical Medicare Payment Amount | 34785.53 |
| Total Medical Medicare Standardized Payment Amount | 35756.84 |
| Average Age Of Beneficiaries | 58 |
| Number Of Beneficiaries Age Less65 | 175 |
| Number Of Beneficiaries Age 65 to 74 | 42 |
| Number Of Beneficiaries Age 75 to 84 | 25 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 175 |
| Number Of Male Beneficiaries | 80 |
| Number Of Non Hispanic White Beneficiaries | 163 |
| Number Of Black or African American Beneficiaries | 67 |
| 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 | 83 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 172 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 31 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.5871 |