| National Provider Identifier [NPI]: | 1861468944 |
| Last Name Of The Provider | DEVINE |
| First Name Of The Provider | SEAN |
| 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 | 1 GUTHRIE SQ |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAYRE |
| Zip Code Of The Provider | 188401625 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 2224 |
| Number Of Medicare Beneficiaries | 798 |
| Total Submitted Charge Amount | 438215 |
| Total Medicare Allowed Amount | 194096.12 |
| Total Medicare Payment Amount | 148096.54 |
| Total Medicare Standardized Payment Amount | 133460.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 17 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 891 |
| Total Drug Medicare AllowedAmount | 685.95 |
| Total Drug Medicare PaymentAmount | 521.35 |
| Total Drug Medicare Standardized Payment Amount | 521.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 2207 |
| Number Of Medicare Beneficiaries With Medical Services | 798 |
| Total Medical Submitted Charge Amount | 437324 |
| Total Medical Medicare Allowed Amount | 193410.17 |
| Total Medical Medicare Payment Amount | 147575.19 |
| Total Medical Medicare Standardized Payment Amount | 132938.75 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 174 |
| Number Of Beneficiaries Age 65 to 74 | 319 |
| Number Of Beneficiaries Age 75 to 84 | 241 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 398 |
| Number Of Male Beneficiaries | 400 |
| Number Of Non Hispanic White Beneficiaries | 779 |
| 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 | 541 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 257 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 51 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.9192 |