| National Provider Identifier [NPI]: | 1811990054 |
| Last Name Of The Provider | FUGATE |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2808 OLD POST ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | HARRISBURG |
| Zip Code Of The Provider | 171103685 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 1866 |
| Number Of Medicare Beneficiaries | 1064 |
| Total Submitted Charge Amount | 170383.75 |
| Total Medicare Allowed Amount | 91804.48 |
| Total Medicare Payment Amount | 66976.13 |
| Total Medicare Standardized Payment Amount | 69675.87 |
| 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 | 42 |
| Number Of Medical Services | 1866 |
| Number Of Medicare Beneficiaries With Medical Services | 1064 |
| Total Medical Submitted Charge Amount | 170383.75 |
| Total Medical Medicare Allowed Amount | 91804.48 |
| Total Medical Medicare Payment Amount | 66976.13 |
| Total Medical Medicare Standardized Payment Amount | 69675.87 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 138 |
| Number Of Beneficiaries Age 65 to 74 | 335 |
| Number Of Beneficiaries Age 75 to 84 | 353 |
| Number Of Beneficiaries Age Greater 84 | 238 |
| Number Of Female Beneficiaries | 566 |
| Number Of Male Beneficiaries | 498 |
| Number Of Non Hispanic White Beneficiaries | 925 |
| Number Of Black or African American Beneficiaries | 93 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 911 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 153 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.7689 |