| National Provider Identifier [NPI]: | 1669462966 |
| Last Name Of The Provider | FISHER |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1106 DRUID RD S |
| Street Address 2 Of The Provider | SUITE 302 |
| City Of The Provider | CLEARWATER |
| Zip Code Of The Provider | 337563846 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 236 |
| Number Of Services | 15939 |
| Number Of Medicare Beneficiaries | 3663 |
| Total Submitted Charge Amount | 1005919.05 |
| Total Medicare Allowed Amount | 225521.16 |
| Total Medicare Payment Amount | 171116.57 |
| Total Medicare Standardized Payment Amount | 173797.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 10420 |
| Number Of Medicare Beneficiaries With Drug Services | 115 |
| Total Drug Submitted ChargeAmount | 26386 |
| Total Drug Medicare AllowedAmount | 2632.79 |
| Total Drug Medicare PaymentAmount | 1986.76 |
| Total Drug Medicare Standardized Payment Amount | 1986.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 233 |
| Number Of Medical Services | 5519 |
| Number Of Medicare Beneficiaries With Medical Services | 3663 |
| Total Medical Submitted Charge Amount | 979533.05 |
| Total Medical Medicare Allowed Amount | 222888.37 |
| Total Medical Medicare Payment Amount | 169129.81 |
| Total Medical Medicare Standardized Payment Amount | 171810.91 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 485 |
| Number Of Beneficiaries Age 65 to 74 | 1093 |
| Number Of Beneficiaries Age 75 to 84 | 1152 |
| Number Of Beneficiaries Age Greater 84 | 933 |
| Number Of Female Beneficiaries | 2191 |
| Number Of Male Beneficiaries | 1472 |
| Number Of Non Hispanic White Beneficiaries | 3332 |
| Number Of Black or African American Beneficiaries | 139 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 121 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2841 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 822 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.9704 |