| National Provider Identifier [NPI]: | 1619062338 |
| Last Name Of The Provider | DEGIVE |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1301 WELL BROOK CIRCLE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CONYERS |
| Zip Code Of The Provider | 300123873 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 3627 |
| Number Of Medicare Beneficiaries | 244 |
| Total Submitted Charge Amount | 251163 |
| Total Medicare Allowed Amount | 108551.18 |
| Total Medicare Payment Amount | 85901.89 |
| Total Medicare Standardized Payment Amount | 86036.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 107 |
| Number Of Medicare Beneficiaries With Drug Services | 101 |
| Total Drug Submitted ChargeAmount | 5494 |
| Total Drug Medicare AllowedAmount | 2078.73 |
| Total Drug Medicare PaymentAmount | 2036.05 |
| Total Drug Medicare Standardized Payment Amount | 2036.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 3520 |
| Number Of Medicare Beneficiaries With Medical Services | 244 |
| Total Medical Submitted Charge Amount | 245669 |
| Total Medical Medicare Allowed Amount | 106472.45 |
| Total Medical Medicare Payment Amount | 83865.84 |
| Total Medical Medicare Standardized Payment Amount | 84000.8 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 104 |
| Number Of Beneficiaries Age 75 to 84 | 94 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 207 |
| Number Of Male Beneficiaries | 37 |
| Number Of Non Hispanic White Beneficiaries | 233 |
| 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 | 233 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 31 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.1089 |