| National Provider Identifier [NPI]: | 1730101155 |
| Last Name Of The Provider | PHILLIPS |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7611 FOREST AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 232294946 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 107 |
| Number Of Services | 16771 |
| Number Of Medicare Beneficiaries | 1363 |
| Total Submitted Charge Amount | 1368806 |
| Total Medicare Allowed Amount | 458038.27 |
| Total Medicare Payment Amount | 341284.16 |
| Total Medicare Standardized Payment Amount | 354044.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 12566 |
| Number Of Medicare Beneficiaries With Drug Services | 111 |
| Total Drug Submitted ChargeAmount | 14310 |
| Total Drug Medicare AllowedAmount | 3151.52 |
| Total Drug Medicare PaymentAmount | 2470.62 |
| Total Drug Medicare Standardized Payment Amount | 2470.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 105 |
| Number Of Medical Services | 4205 |
| Number Of Medicare Beneficiaries With Medical Services | 1363 |
| Total Medical Submitted Charge Amount | 1354496 |
| Total Medical Medicare Allowed Amount | 454886.75 |
| Total Medical Medicare Payment Amount | 338813.54 |
| Total Medical Medicare Standardized Payment Amount | 351573.98 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 532 |
| Number Of Beneficiaries Age 75 to 84 | 489 |
| Number Of Beneficiaries Age Greater 84 | 276 |
| Number Of Female Beneficiaries | 637 |
| Number Of Male Beneficiaries | 726 |
| Number Of Non Hispanic White Beneficiaries | 1182 |
| Number Of Black or African American Beneficiaries | 150 |
| 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 | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1262 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 101 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 71 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.5939 |