| National Provider Identifier [NPI]: | 1154300101 |
| Last Name Of The Provider | PHILLIPS |
| First Name Of The Provider | JENNIFER |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7230 W 129TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | OVERLAND PARK |
| Zip Code Of The Provider | 662132624 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 3252 |
| Number Of Medicare Beneficiaries | 554 |
| Total Submitted Charge Amount | 320267.2 |
| Total Medicare Allowed Amount | 167890.98 |
| Total Medicare Payment Amount | 119891.26 |
| Total Medicare Standardized Payment Amount | 132066.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 126 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 1446.3 |
| Total Drug Medicare AllowedAmount | 380.28 |
| Total Drug Medicare PaymentAmount | 290.33 |
| Total Drug Medicare Standardized Payment Amount | 290.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 3126 |
| Number Of Medicare Beneficiaries With Medical Services | 554 |
| Total Medical Submitted Charge Amount | 318820.9 |
| Total Medical Medicare Allowed Amount | 167510.7 |
| Total Medical Medicare Payment Amount | 119600.93 |
| Total Medical Medicare Standardized Payment Amount | 131776.43 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 215 |
| Number Of Beneficiaries Age 75 to 84 | 167 |
| Number Of Beneficiaries Age Greater 84 | 129 |
| Number Of Female Beneficiaries | 326 |
| Number Of Male Beneficiaries | 228 |
| Number Of Non Hispanic White Beneficiaries | 525 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 517 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3691 |