| National Provider Identifier [NPI]: | 1114926797 |
| Last Name Of The Provider | PHILLIPS |
| First Name Of The Provider | J |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8 RICHLAND MEDICAL PARK DR |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | COLUMBIA |
| Zip Code Of The Provider | 292038005 |
| State Code Of The Provider | SC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 122 |
| Number Of Services | 12865 |
| Number Of Medicare Beneficiaries | 2046 |
| Total Submitted Charge Amount | 1800575.55 |
| Total Medicare Allowed Amount | 815586.21 |
| Total Medicare Payment Amount | 607535.63 |
| Total Medicare Standardized Payment Amount | 655114.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 2592 |
| Number Of Medicare Beneficiaries With Drug Services | 191 |
| Total Drug Submitted ChargeAmount | 56967 |
| Total Drug Medicare AllowedAmount | 36807.47 |
| Total Drug Medicare PaymentAmount | 28856.93 |
| Total Drug Medicare Standardized Payment Amount | 28856.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 117 |
| Number Of Medical Services | 10273 |
| Number Of Medicare Beneficiaries With Medical Services | 2046 |
| Total Medical Submitted Charge Amount | 1743608.55 |
| Total Medical Medicare Allowed Amount | 778778.74 |
| Total Medical Medicare Payment Amount | 578678.7 |
| Total Medical Medicare Standardized Payment Amount | 626257.21 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 253 |
| Number Of Beneficiaries Age 65 to 74 | 879 |
| Number Of Beneficiaries Age 75 to 84 | 619 |
| Number Of Beneficiaries Age Greater 84 | 295 |
| Number Of Female Beneficiaries | 1074 |
| Number Of Male Beneficiaries | 972 |
| Number Of Non Hispanic White Beneficiaries | 1448 |
| Number Of Black or African American Beneficiaries | 546 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1734 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 312 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5413 |