| National Provider Identifier [NPI]: | 1588669691 |
| Last Name Of The Provider | FISHER |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1811 HIGHWAY 287 N |
| Street Address 2 Of The Provider | STE 150 |
| City Of The Provider | MANSFIELD |
| Zip Code Of The Provider | 760637595 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 2542 |
| Number Of Medicare Beneficiaries | 613 |
| Total Submitted Charge Amount | 164324.6 |
| Total Medicare Allowed Amount | 117007.56 |
| Total Medicare Payment Amount | 78810.05 |
| Total Medicare Standardized Payment Amount | 80314.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 577 |
| Number Of Medicare Beneficiaries With Drug Services | 155 |
| Total Drug Submitted ChargeAmount | 6736.6 |
| Total Drug Medicare AllowedAmount | 2818.55 |
| Total Drug Medicare PaymentAmount | 2528.68 |
| Total Drug Medicare Standardized Payment Amount | 2528.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 1965 |
| Number Of Medicare Beneficiaries With Medical Services | 613 |
| Total Medical Submitted Charge Amount | 157588 |
| Total Medical Medicare Allowed Amount | 114189.01 |
| Total Medical Medicare Payment Amount | 76281.37 |
| Total Medical Medicare Standardized Payment Amount | 77785.7 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 359 |
| Number Of Beneficiaries Age 75 to 84 | 137 |
| Number Of Beneficiaries Age Greater 84 | 42 |
| Number Of Female Beneficiaries | 398 |
| Number Of Male Beneficiaries | 215 |
| Number Of Non Hispanic White Beneficiaries | 484 |
| Number Of Black or African American Beneficiaries | 70 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 578 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.8921 |