| National Provider Identifier [NPI]: | 1811198005 |
| Last Name Of The Provider | CHUSTZ |
| First Name Of The Provider | PHILIP |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 970 LAKELAND DR |
| Street Address 2 Of The Provider | SUITE 61 |
| City Of The Provider | JACKSON |
| Zip Code Of The Provider | 392164635 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 78 |
| Number Of Services | 9053 |
| Number Of Medicare Beneficiaries | 1183 |
| Total Submitted Charge Amount | 1410444.5 |
| Total Medicare Allowed Amount | 390738.75 |
| Total Medicare Payment Amount | 292028.13 |
| Total Medicare Standardized Payment Amount | 313877.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 4406 |
| Number Of Medicare Beneficiaries With Drug Services | 118 |
| Total Drug Submitted ChargeAmount | 25992.5 |
| Total Drug Medicare AllowedAmount | 17510.16 |
| Total Drug Medicare PaymentAmount | 13273.85 |
| Total Drug Medicare Standardized Payment Amount | 13273.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 4647 |
| Number Of Medicare Beneficiaries With Medical Services | 1183 |
| Total Medical Submitted Charge Amount | 1384452 |
| Total Medical Medicare Allowed Amount | 373228.59 |
| Total Medical Medicare Payment Amount | 278754.28 |
| Total Medical Medicare Standardized Payment Amount | 300603.6 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 165 |
| Number Of Beneficiaries Age 65 to 74 | 481 |
| Number Of Beneficiaries Age 75 to 84 | 357 |
| Number Of Beneficiaries Age Greater 84 | 180 |
| Number Of Female Beneficiaries | 672 |
| Number Of Male Beneficiaries | 511 |
| Number Of Non Hispanic White Beneficiaries | 901 |
| 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 | 921 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 262 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.4983 |