| National Provider Identifier [NPI]: | 1003948753 |
| Last Name Of The Provider | FITZER |
| First Name Of The Provider | MELODY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2700 BLACKBERRY LN NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRAND RAPIDS |
| Zip Code Of The Provider | 495259760 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 532 |
| Number Of Medicare Beneficiaries | 428 |
| Total Submitted Charge Amount | 411964.45 |
| Total Medicare Allowed Amount | 76476.11 |
| Total Medicare Payment Amount | 58680.93 |
| Total Medicare Standardized Payment Amount | 59269.54 |
| 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 | 15 |
| Number Of Medical Services | 532 |
| Number Of Medicare Beneficiaries With Medical Services | 428 |
| Total Medical Submitted Charge Amount | 411964.45 |
| Total Medical Medicare Allowed Amount | 76476.11 |
| Total Medical Medicare Payment Amount | 58680.93 |
| Total Medical Medicare Standardized Payment Amount | 59269.54 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 150 |
| Number Of Beneficiaries Age 65 to 74 | 124 |
| Number Of Beneficiaries Age 75 to 84 | 104 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 236 |
| Number Of Male Beneficiaries | 192 |
| Number Of Non Hispanic White Beneficiaries | 413 |
| Number Of Black or African American Beneficiaries | |
| 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 | 242 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 186 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6987 |