| National Provider Identifier [NPI]: | 1417157926 |
| Last Name Of The Provider | FRY |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1850 W ARLINGTON BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GREENVILLE |
| Zip Code Of The Provider | 278345704 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 244 |
| Number Of Services | 26803.5 |
| Number Of Medicare Beneficiaries | 990 |
| Total Submitted Charge Amount | 1472564.18 |
| Total Medicare Allowed Amount | 654384.8 |
| Total Medicare Payment Amount | 532768.85 |
| Total Medicare Standardized Payment Amount | 556074.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 20 |
| Number Of Drug Services | 12005.5 |
| Number Of Medicare Beneficiaries With Drug Services | 450 |
| Total Drug Submitted ChargeAmount | 164054.08 |
| Total Drug Medicare AllowedAmount | 63311.52 |
| Total Drug Medicare PaymentAmount | 55179.51 |
| Total Drug Medicare Standardized Payment Amount | 55179.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 224 |
| Number Of Medical Services | 14798 |
| Number Of Medicare Beneficiaries With Medical Services | 990 |
| Total Medical Submitted Charge Amount | 1308510.1 |
| Total Medical Medicare Allowed Amount | 591073.28 |
| Total Medical Medicare Payment Amount | 477589.34 |
| Total Medical Medicare Standardized Payment Amount | 500895.46 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 91 |
| Number Of Beneficiaries Age 65 to 74 | 474 |
| Number Of Beneficiaries Age 75 to 84 | 324 |
| Number Of Beneficiaries Age Greater 84 | 101 |
| Number Of Female Beneficiaries | 684 |
| Number Of Male Beneficiaries | 306 |
| Number Of Non Hispanic White Beneficiaries | 789 |
| Number Of Black or African American Beneficiaries | 186 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 912 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 78 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0381 |