| National Provider Identifier [NPI]: | 1033112081 |
| Last Name Of The Provider | FOGARTY |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| 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 | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 125 |
| Number Of Services | 11166 |
| Number Of Medicare Beneficiaries | 2533 |
| Total Submitted Charge Amount | 1239165.7 |
| Total Medicare Allowed Amount | 500274.52 |
| Total Medicare Payment Amount | 378126.13 |
| Total Medicare Standardized Payment Amount | 402308.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 4479 |
| Number Of Medicare Beneficiaries With Drug Services | 129 |
| Total Drug Submitted ChargeAmount | 17820 |
| Total Drug Medicare AllowedAmount | 9980.27 |
| Total Drug Medicare PaymentAmount | 8714.48 |
| Total Drug Medicare Standardized Payment Amount | 8714.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 117 |
| Number Of Medical Services | 6687 |
| Number Of Medicare Beneficiaries With Medical Services | 2533 |
| Total Medical Submitted Charge Amount | 1221345.7 |
| Total Medical Medicare Allowed Amount | 490294.25 |
| Total Medical Medicare Payment Amount | 369411.65 |
| Total Medical Medicare Standardized Payment Amount | 393593.86 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 440 |
| Number Of Beneficiaries Age 65 to 74 | 1146 |
| Number Of Beneficiaries Age 75 to 84 | 750 |
| Number Of Beneficiaries Age Greater 84 | 197 |
| Number Of Female Beneficiaries | 1470 |
| Number Of Male Beneficiaries | 1063 |
| Number Of Non Hispanic White Beneficiaries | 1984 |
| Number Of Black or African American Beneficiaries | 510 |
| 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 | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2079 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 454 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4369 |