| National Provider Identifier [NPI]: | 1316244643 |
| Last Name Of The Provider | PHILLIPS |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MSN,FNP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1150 E COLLEGE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PULASKI |
| Zip Code Of The Provider | 384784519 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 1292 |
| Number Of Medicare Beneficiaries | 151 |
| Total Submitted Charge Amount | 108212.79 |
| Total Medicare Allowed Amount | 58265.49 |
| Total Medicare Payment Amount | 42613.16 |
| Total Medicare Standardized Payment Amount | 53665.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 358 |
| Number Of Medicare Beneficiaries With Drug Services | 64 |
| Total Drug Submitted ChargeAmount | 16427.5 |
| Total Drug Medicare AllowedAmount | 7388.79 |
| Total Drug Medicare PaymentAmount | 5802.94 |
| Total Drug Medicare Standardized Payment Amount | 5802.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 934 |
| Number Of Medicare Beneficiaries With Medical Services | 151 |
| Total Medical Submitted Charge Amount | 91785.29 |
| Total Medical Medicare Allowed Amount | 50876.7 |
| Total Medical Medicare Payment Amount | 36810.22 |
| Total Medical Medicare Standardized Payment Amount | 47862.37 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 58 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 98 |
| Number Of Male Beneficiaries | 53 |
| Number Of Non Hispanic White Beneficiaries | 127 |
| 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 | 98 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 0 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0912 |