| National Provider Identifier [NPI]: | 1366440273 |
| Last Name Of The Provider | FOGEL |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2605 BLUE RIDGE RD |
| Street Address 2 Of The Provider | STE 220 |
| City Of The Provider | RALEIGH |
| Zip Code Of The Provider | 27607 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 8467 |
| Number Of Medicare Beneficiaries | 365 |
| Total Submitted Charge Amount | 3211153 |
| Total Medicare Allowed Amount | 1823451.4 |
| Total Medicare Payment Amount | 1404398.21 |
| Total Medicare Standardized Payment Amount | 1417179.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 4053 |
| Number Of Medicare Beneficiaries With Drug Services | 124 |
| Total Drug Submitted ChargeAmount | 2007715 |
| Total Drug Medicare AllowedAmount | 1509356.98 |
| Total Drug Medicare PaymentAmount | 1166316.71 |
| Total Drug Medicare Standardized Payment Amount | 1166316.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 4414 |
| Number Of Medicare Beneficiaries With Medical Services | 365 |
| Total Medical Submitted Charge Amount | 1203438 |
| Total Medical Medicare Allowed Amount | 314094.42 |
| Total Medical Medicare Payment Amount | 238081.5 |
| Total Medical Medicare Standardized Payment Amount | 250862.64 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 145 |
| Number Of Beneficiaries Age 75 to 84 | 117 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 218 |
| Number Of Male Beneficiaries | 147 |
| Number Of Non Hispanic White Beneficiaries | 295 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 332 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 33 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2822 |