| National Provider Identifier [NPI]: | 1922079599 |
| Last Name Of The Provider | FINE |
| First Name Of The Provider | IRA |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10753 FALLS RD |
| Street Address 2 Of The Provider | SUITE 225 |
| City Of The Provider | LUTHERVILLE |
| Zip Code Of The Provider | 210934535 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 12021 |
| Number Of Medicare Beneficiaries | 398 |
| Total Submitted Charge Amount | 589569.17 |
| Total Medicare Allowed Amount | 341018.23 |
| Total Medicare Payment Amount | 260758.28 |
| Total Medicare Standardized Payment Amount | 260172 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 10408 |
| Number Of Medicare Beneficiaries With Drug Services | 139 |
| Total Drug Submitted ChargeAmount | 458508.22 |
| Total Drug Medicare AllowedAmount | 228972.96 |
| Total Drug Medicare PaymentAmount | 177118.31 |
| Total Drug Medicare Standardized Payment Amount | 177118.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 1613 |
| Number Of Medicare Beneficiaries With Medical Services | 398 |
| Total Medical Submitted Charge Amount | 131060.95 |
| Total Medical Medicare Allowed Amount | 112045.27 |
| Total Medical Medicare Payment Amount | 83639.97 |
| Total Medical Medicare Standardized Payment Amount | 83053.69 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 135 |
| Number Of Beneficiaries Age 75 to 84 | 147 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 249 |
| Number Of Male Beneficiaries | 149 |
| Number Of Non Hispanic White Beneficiaries | 371 |
| 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 | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 12 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0968 |