National Provider Identifier [NPI]: |
1891738183 |
Last Name Of The Provider |
FISCHER |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4039 GATEWAY BLVD |
Street Address 2 Of The Provider |
GATEWAY BLVD |
City Of The Provider |
GROVETOWN |
Zip Code Of The Provider |
308133195 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
173 |
Number Of Services |
13408 |
Number Of Medicare Beneficiaries |
762 |
Total Submitted Charge Amount |
1351820 |
Total Medicare Allowed Amount |
440971.02 |
Total Medicare Payment Amount |
340174.63 |
Total Medicare Standardized Payment Amount |
361904.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
20 |
Number Of Drug Services |
2883 |
Number Of Medicare Beneficiaries With Drug Services |
415 |
Total Drug Submitted ChargeAmount |
81375 |
Total Drug Medicare AllowedAmount |
32144.29 |
Total Drug Medicare PaymentAmount |
26823.95 |
Total Drug Medicare Standardized Payment Amount |
26823.95 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
153 |
Number Of Medical Services |
10525 |
Number Of Medicare Beneficiaries With Medical Services |
761 |
Total Medical Submitted Charge Amount |
1270445 |
Total Medical Medicare Allowed Amount |
408826.73 |
Total Medical Medicare Payment Amount |
313350.68 |
Total Medical Medicare Standardized Payment Amount |
335080.28 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
405 |
Number Of Beneficiaries Age 75 to 84 |
217 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
435 |
Number Of Male Beneficiaries |
327 |
Number Of Non Hispanic White Beneficiaries |
661 |
Number Of Black or African American Beneficiaries |
52 |
Number Of AsianPacific Islander Beneficiaries |
28 |
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 |
721 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
24 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.8654 |