| National Provider Identifier [NPI]: | 1174637532 |
| Last Name Of The Provider | DEVINE |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 275 COLLIER RD NW |
| Street Address 2 Of The Provider | STE 450 |
| City Of The Provider | ATLANTA |
| Zip Code Of The Provider | 303091709 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 9381 |
| Number Of Medicare Beneficiaries | 447 |
| Total Submitted Charge Amount | 794832 |
| Total Medicare Allowed Amount | 249645.91 |
| Total Medicare Payment Amount | 193387.36 |
| Total Medicare Standardized Payment Amount | 194174.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 7353 |
| Number Of Medicare Beneficiaries With Drug Services | 85 |
| Total Drug Submitted ChargeAmount | 348506 |
| Total Drug Medicare AllowedAmount | 88009.45 |
| Total Drug Medicare PaymentAmount | 69448.59 |
| Total Drug Medicare Standardized Payment Amount | 69448.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 2028 |
| Number Of Medicare Beneficiaries With Medical Services | 445 |
| Total Medical Submitted Charge Amount | 446326 |
| Total Medical Medicare Allowed Amount | 161636.46 |
| Total Medical Medicare Payment Amount | 123938.77 |
| Total Medical Medicare Standardized Payment Amount | 124725.57 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 113 |
| Number Of Beneficiaries Age 65 to 74 | 173 |
| Number Of Beneficiaries Age 75 to 84 | 100 |
| Number Of Beneficiaries Age Greater 84 | 61 |
| Number Of Female Beneficiaries | 214 |
| Number Of Male Beneficiaries | 233 |
| Number Of Non Hispanic White Beneficiaries | 288 |
| Number Of Black or African American Beneficiaries | 136 |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 366 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 81 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.9499 |