| National Provider Identifier [NPI]: | 1639381346 |
| Last Name Of The Provider | PRINS |
| First Name Of The Provider | RENEE |
| 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 | 3710 SW US VETERANS HOSPITAL RD |
| Street Address 2 Of The Provider | P3MED |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 972392964 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 34429 |
| Number Of Medicare Beneficiaries | 183 |
| Total Submitted Charge Amount | 1318015.96 |
| Total Medicare Allowed Amount | 613470.21 |
| Total Medicare Payment Amount | 445524.86 |
| Total Medicare Standardized Payment Amount | 449354.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 42 |
| Number Of Drug Services | 32010 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 965211.04 |
| Total Drug Medicare AllowedAmount | 495783 |
| Total Drug Medicare PaymentAmount | 355753.11 |
| Total Drug Medicare Standardized Payment Amount | 355753.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 2419 |
| Number Of Medicare Beneficiaries With Medical Services | 183 |
| Total Medical Submitted Charge Amount | 352804.92 |
| Total Medical Medicare Allowed Amount | 117687.21 |
| Total Medical Medicare Payment Amount | 89771.75 |
| Total Medical Medicare Standardized Payment Amount | 93601.66 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 85 |
| Number Of Beneficiaries Age 75 to 84 | 41 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 110 |
| Number Of Male Beneficiaries | 73 |
| Number Of Non Hispanic White Beneficiaries | 164 |
| Number Of Black or African American Beneficiaries | |
| 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 | 140 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 34 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.9683 |