| National Provider Identifier [NPI]: | 1093797821 |
| Last Name Of The Provider | FISHER |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1800 E PARK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | STATE COLLEGE |
| Zip Code Of The Provider | 168036701 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 130 |
| Number Of Services | 5898 |
| Number Of Medicare Beneficiaries | 2759 |
| Total Submitted Charge Amount | 1078322.15 |
| Total Medicare Allowed Amount | 157992.56 |
| Total Medicare Payment Amount | 122810.36 |
| Total Medicare Standardized Payment Amount | 130163.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2040 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 7441.15 |
| Total Drug Medicare AllowedAmount | 755.53 |
| Total Drug Medicare PaymentAmount | 534.32 |
| Total Drug Medicare Standardized Payment Amount | 534.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 127 |
| Number Of Medical Services | 3858 |
| Number Of Medicare Beneficiaries With Medical Services | 2759 |
| Total Medical Submitted Charge Amount | 1070881 |
| Total Medical Medicare Allowed Amount | 157237.03 |
| Total Medical Medicare Payment Amount | 122276.04 |
| Total Medical Medicare Standardized Payment Amount | 129628.98 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 663 |
| Number Of Beneficiaries Age 65 to 74 | 1060 |
| Number Of Beneficiaries Age 75 to 84 | 661 |
| Number Of Beneficiaries Age Greater 84 | 375 |
| Number Of Female Beneficiaries | 1660 |
| Number Of Male Beneficiaries | 1099 |
| Number Of Non Hispanic White Beneficiaries | 2643 |
| Number Of Black or African American Beneficiaries | 32 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1920 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 839 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7439 |