| National Provider Identifier [NPI]: | 1982646121 |
| Last Name Of The Provider | FINE |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7777 FOREST LN |
| Street Address 2 Of The Provider | BLDG D, SUITE 400 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752302505 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gynecological/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 127 |
| Number Of Services | 39597 |
| Number Of Medicare Beneficiaries | 176 |
| Total Submitted Charge Amount | 1288904 |
| Total Medicare Allowed Amount | 297278.45 |
| Total Medicare Payment Amount | 225559.85 |
| Total Medicare Standardized Payment Amount | 231369.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 25 |
| Number Of Drug Services | 37714 |
| Number Of Medicare Beneficiaries With Drug Services | 58 |
| Total Drug Submitted ChargeAmount | 695197 |
| Total Drug Medicare AllowedAmount | 142246.37 |
| Total Drug Medicare PaymentAmount | 107393.2 |
| Total Drug Medicare Standardized Payment Amount | 107393.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 102 |
| Number Of Medical Services | 1883 |
| Number Of Medicare Beneficiaries With Medical Services | 176 |
| Total Medical Submitted Charge Amount | 593707 |
| Total Medical Medicare Allowed Amount | 155032.08 |
| Total Medical Medicare Payment Amount | 118166.65 |
| Total Medical Medicare Standardized Payment Amount | 123975.9 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 94 |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | 136 |
| Number Of Black or African American Beneficiaries | 17 |
| 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 | 145 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.8012 |