| National Provider Identifier [NPI]: | 1720164130 |
| Last Name Of The Provider | DIVITTORIO |
| First Name Of The Provider | ADRIAN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1700 SPRING HILL AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MOBILE |
| Zip Code Of The Provider | 366041407 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 3923 |
| Number Of Medicare Beneficiaries | 949 |
| Total Submitted Charge Amount | 623860 |
| Total Medicare Allowed Amount | 323878.51 |
| Total Medicare Payment Amount | 245438.05 |
| Total Medicare Standardized Payment Amount | 265680.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 141 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 873 |
| Total Drug Medicare AllowedAmount | 328.99 |
| Total Drug Medicare PaymentAmount | 302.76 |
| Total Drug Medicare Standardized Payment Amount | 302.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 110 |
| Number Of Medical Services | 3782 |
| Number Of Medicare Beneficiaries With Medical Services | 949 |
| Total Medical Submitted Charge Amount | 622987 |
| Total Medical Medicare Allowed Amount | 323549.52 |
| Total Medical Medicare Payment Amount | 245135.29 |
| Total Medical Medicare Standardized Payment Amount | 265377.41 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 223 |
| Number Of Beneficiaries Age 65 to 74 | 362 |
| Number Of Beneficiaries Age 75 to 84 | 253 |
| Number Of Beneficiaries Age Greater 84 | 111 |
| Number Of Female Beneficiaries | 503 |
| Number Of Male Beneficiaries | 446 |
| Number Of Non Hispanic White Beneficiaries | 642 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 722 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 227 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 41 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.0034 |