| National Provider Identifier [NPI]: | 1033248786 |
| Last Name Of The Provider | FITZGERALD |
| First Name Of The Provider | CHERYL |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3066 E MERIDIAN PARK LOOP |
| Street Address 2 Of The Provider | |
| City Of The Provider | WASILLA |
| Zip Code Of The Provider | 996547372 |
| State Code Of The Provider | AK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 1676 |
| Number Of Medicare Beneficiaries | 201 |
| Total Submitted Charge Amount | 431797 |
| Total Medicare Allowed Amount | 115590.37 |
| Total Medicare Payment Amount | 85216.02 |
| Total Medicare Standardized Payment Amount | 82261.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 132 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 9677 |
| Total Drug Medicare AllowedAmount | 1924.09 |
| Total Drug Medicare PaymentAmount | 1499.56 |
| Total Drug Medicare Standardized Payment Amount | 1499.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 1544 |
| Number Of Medicare Beneficiaries With Medical Services | 201 |
| Total Medical Submitted Charge Amount | 422120 |
| Total Medical Medicare Allowed Amount | 113666.28 |
| Total Medical Medicare Payment Amount | 83716.46 |
| Total Medical Medicare Standardized Payment Amount | 80761.77 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 114 |
| Number Of Beneficiaries Age 65 to 74 | 64 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 130 |
| Number Of Male Beneficiaries | 71 |
| Number Of Non Hispanic White Beneficiaries | 176 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 87 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 114 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4213 |