| National Provider Identifier [NPI]: | 1578599676 |
| Last Name Of The Provider | DEVINE |
| First Name Of The Provider | MALON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | CRNA, ARNP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 SE 2ND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DELRAY BEACH |
| Zip Code Of The Provider | 334443615 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | CRNA |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 1189 |
| Number Of Medicare Beneficiaries | 1010 |
| Total Submitted Charge Amount | 375112.79 |
| Total Medicare Allowed Amount | 118625.18 |
| Total Medicare Payment Amount | 92169.31 |
| Total Medicare Standardized Payment Amount | 86629.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 1189 |
| Number Of Medicare Beneficiaries With Medical Services | 1010 |
| Total Medical Submitted Charge Amount | 375112.79 |
| Total Medical Medicare Allowed Amount | 118625.18 |
| Total Medical Medicare Payment Amount | 92169.31 |
| Total Medical Medicare Standardized Payment Amount | 86629.7 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 401 |
| Number Of Beneficiaries Age 75 to 84 | 394 |
| Number Of Beneficiaries Age Greater 84 | 168 |
| Number Of Female Beneficiaries | 585 |
| Number Of Male Beneficiaries | 425 |
| Number Of Non Hispanic White Beneficiaries | 926 |
| Number Of Black or African American Beneficiaries | 31 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 942 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 68 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3418 |