| National Provider Identifier [NPI]: | 1861501991 |
| Last Name Of The Provider | PRINCE |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2240 SUTHERLAND AVE |
| Street Address 2 Of The Provider | SUITE 103 |
| City Of The Provider | KNOXVILLE |
| Zip Code Of The Provider | 379192333 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 1892 |
| Number Of Medicare Beneficiaries | 449 |
| Total Submitted Charge Amount | 421857.06 |
| Total Medicare Allowed Amount | 192178.18 |
| Total Medicare Payment Amount | 146583.92 |
| Total Medicare Standardized Payment Amount | 154539.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 19 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 860 |
| Total Drug Medicare AllowedAmount | 694.04 |
| Total Drug Medicare PaymentAmount | 678.36 |
| Total Drug Medicare Standardized Payment Amount | 678.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 1873 |
| Number Of Medicare Beneficiaries With Medical Services | 449 |
| Total Medical Submitted Charge Amount | 420997.06 |
| Total Medical Medicare Allowed Amount | 191484.14 |
| Total Medical Medicare Payment Amount | 145905.56 |
| Total Medical Medicare Standardized Payment Amount | 153861.26 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 192 |
| Number Of Beneficiaries Age 75 to 84 | 131 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 232 |
| Number Of Male Beneficiaries | 217 |
| Number Of Non Hispanic White Beneficiaries | 428 |
| Number Of Black or African American Beneficiaries | |
| 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 | 354 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 95 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 22 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 61 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.2237 |