| National Provider Identifier [NPI]: | 1437259116 |
| Last Name Of The Provider | PHILLIPS |
| First Name Of The Provider | SARAH |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1025 S 6TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 627032403 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 94 |
| Number Of Services | 1502 |
| Number Of Medicare Beneficiaries | 726 |
| Total Submitted Charge Amount | 188655.51 |
| Total Medicare Allowed Amount | 68983.1 |
| Total Medicare Payment Amount | 43577.83 |
| Total Medicare Standardized Payment Amount | 45244.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 38 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 1181.35 |
| Total Drug Medicare AllowedAmount | 366.55 |
| Total Drug Medicare PaymentAmount | 268.34 |
| Total Drug Medicare Standardized Payment Amount | 268.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 85 |
| Number Of Medical Services | 1464 |
| Number Of Medicare Beneficiaries With Medical Services | 726 |
| Total Medical Submitted Charge Amount | 187474.16 |
| Total Medical Medicare Allowed Amount | 68616.55 |
| Total Medical Medicare Payment Amount | 43309.49 |
| Total Medical Medicare Standardized Payment Amount | 44976.49 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 295 |
| Number Of Beneficiaries Age 75 to 84 | 266 |
| Number Of Beneficiaries Age Greater 84 | 132 |
| Number Of Female Beneficiaries | 448 |
| Number Of Male Beneficiaries | 278 |
| Number Of Non Hispanic White Beneficiaries | 714 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 701 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0011 |