| National Provider Identifier [NPI]: | 1659306975 |
| Last Name Of The Provider | PRINCE |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1490 E FOREMASTER DR |
| Street Address 2 Of The Provider | #150 |
| City Of The Provider | ST GEORGE |
| Zip Code Of The Provider | 847904488 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 143 |
| Number Of Services | 5531 |
| Number Of Medicare Beneficiaries | 668 |
| Total Submitted Charge Amount | 1220389 |
| Total Medicare Allowed Amount | 475839.69 |
| Total Medicare Payment Amount | 359925.91 |
| Total Medicare Standardized Payment Amount | 372256.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 3221 |
| Number Of Medicare Beneficiaries With Drug Services | 254 |
| Total Drug Submitted ChargeAmount | 66189 |
| Total Drug Medicare AllowedAmount | 26991.35 |
| Total Drug Medicare PaymentAmount | 20510.22 |
| Total Drug Medicare Standardized Payment Amount | 20510.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 137 |
| Number Of Medical Services | 2310 |
| Number Of Medicare Beneficiaries With Medical Services | 668 |
| Total Medical Submitted Charge Amount | 1154200 |
| Total Medical Medicare Allowed Amount | 448848.34 |
| Total Medical Medicare Payment Amount | 339415.69 |
| Total Medical Medicare Standardized Payment Amount | 351745.91 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 342 |
| Number Of Beneficiaries Age 75 to 84 | 204 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 396 |
| Number Of Male Beneficiaries | 272 |
| Number Of Non Hispanic White Beneficiaries | 639 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 617 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 71 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 1.0002 |