| National Provider Identifier [NPI]: | 1215020359 |
| Last Name Of The Provider | PHILLIPS-DEINES |
| First Name Of The Provider | PENNY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5826 ESPLANADE DR |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | CORPUS CHRISTI |
| Zip Code Of The Provider | 784144173 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 1111 |
| Number Of Medicare Beneficiaries | 286 |
| Total Submitted Charge Amount | 107345 |
| Total Medicare Allowed Amount | 74265.1 |
| Total Medicare Payment Amount | 52351.46 |
| Total Medicare Standardized Payment Amount | 56172.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 33 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 445 |
| Total Drug Medicare AllowedAmount | 166.04 |
| Total Drug Medicare PaymentAmount | 120.17 |
| Total Drug Medicare Standardized Payment Amount | 120.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 1078 |
| Number Of Medicare Beneficiaries With Medical Services | 286 |
| Total Medical Submitted Charge Amount | 106900 |
| Total Medical Medicare Allowed Amount | 74099.06 |
| Total Medical Medicare Payment Amount | 52231.29 |
| Total Medical Medicare Standardized Payment Amount | 56052.5 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 72 |
| Number Of Beneficiaries Age 65 to 74 | 101 |
| Number Of Beneficiaries Age 75 to 84 | 69 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 183 |
| Number Of Male Beneficiaries | 103 |
| Number Of Non Hispanic White Beneficiaries | 145 |
| 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 | 193 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 93 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4189 |