| National Provider Identifier [NPI]: | 1659562726 |
| Last Name Of The Provider | PHILLIPS |
| First Name Of The Provider | ROB |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PHYSICIAN ASSISTANT |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7 S MICKEY MANTLE DR |
| Street Address 2 Of The Provider | SUITE 325 |
| City Of The Provider | OKLAHOMA CITY |
| Zip Code Of The Provider | 731042458 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 2 |
| Number Of Services | 859 |
| Number Of Medicare Beneficiaries | 368 |
| Total Submitted Charge Amount | 126235.59 |
| Total Medicare Allowed Amount | 87713.63 |
| Total Medicare Payment Amount | 57943.16 |
| Total Medicare Standardized Payment Amount | 75980.13 |
| 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 | 2 |
| Number Of Medical Services | 859 |
| Number Of Medicare Beneficiaries With Medical Services | 368 |
| Total Medical Submitted Charge Amount | 126235.59 |
| Total Medical Medicare Allowed Amount | 87713.63 |
| Total Medical Medicare Payment Amount | 57943.16 |
| Total Medical Medicare Standardized Payment Amount | 75980.13 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 141 |
| Number Of Beneficiaries Age 65 to 74 | 96 |
| Number Of Beneficiaries Age 75 to 84 | 75 |
| Number Of Beneficiaries Age Greater 84 | 56 |
| Number Of Female Beneficiaries | 190 |
| Number Of Male Beneficiaries | 178 |
| Number Of Non Hispanic White Beneficiaries | 235 |
| Number Of Black or African American Beneficiaries | 106 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 106 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 262 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 55 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.4603 |