| National Provider Identifier [NPI]: | 1447235643 |
| Last Name Of The Provider | PHILLIPS |
| First Name Of The Provider | VAL |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 MEDICAL CENTER BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAWRENCEVILLE |
| Zip Code Of The Provider | 300467694 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 173 |
| Number Of Services | 6443 |
| Number Of Medicare Beneficiaries | 4118 |
| Total Submitted Charge Amount | 1171351 |
| Total Medicare Allowed Amount | 319500.23 |
| Total Medicare Payment Amount | 243668.4 |
| Total Medicare Standardized Payment Amount | 246666.83 |
| Drug Suppress Indicator | * |
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| Number Of Medicare Beneficiaries With Drug Services | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 647 |
| Number Of Beneficiaries Age 65 to 74 | 1896 |
| Number Of Beneficiaries Age 75 to 84 | 1111 |
| Number Of Beneficiaries Age Greater 84 | 464 |
| Number Of Female Beneficiaries | 2490 |
| Number Of Male Beneficiaries | 1628 |
| Number Of Non Hispanic White Beneficiaries | 3177 |
| Number Of Black or African American Beneficiaries | 502 |
| Number Of AsianPacific Islander Beneficiaries | 177 |
| Number Of Hispanic Beneficiaries | 191 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3349 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 769 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3799 |