| National Provider Identifier [NPI]: | 1407858699 |
| Last Name Of The Provider | PRINCE-FIOCCO |
| First Name Of The Provider | MARILYNN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1090 MEDICAL CENTER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | WILMINGTON |
| Zip Code Of The Provider | 284017353 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 989 |
| Number Of Medicare Beneficiaries | 383 |
| Total Submitted Charge Amount | 157471.44 |
| Total Medicare Allowed Amount | 76191.46 |
| Total Medicare Payment Amount | 57351.27 |
| Total Medicare Standardized Payment Amount | 60028.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 20 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 782.95 |
| Total Drug Medicare AllowedAmount | 558.28 |
| Total Drug Medicare PaymentAmount | 547.01 |
| Total Drug Medicare Standardized Payment Amount | 547.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 969 |
| Number Of Medicare Beneficiaries With Medical Services | 383 |
| Total Medical Submitted Charge Amount | 156688.49 |
| Total Medical Medicare Allowed Amount | 75633.18 |
| Total Medical Medicare Payment Amount | 56804.26 |
| Total Medical Medicare Standardized Payment Amount | 59481.29 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 174 |
| Number Of Beneficiaries Age 75 to 84 | 110 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 200 |
| Number Of Male Beneficiaries | 183 |
| Number Of Non Hispanic White Beneficiaries | 313 |
| Number Of Black or African American Beneficiaries | 46 |
| 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 | 306 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 77 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 26 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 68 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.9256 |