| National Provider Identifier [NPI]: | 1033169438 |
| Last Name Of The Provider | FISHER |
| First Name Of The Provider | DAVID |
| 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 | 2414 KOHLER MEMORIAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHEBOYGAN |
| Zip Code Of The Provider | 530813129 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 184 |
| Number Of Services | 13919 |
| Number Of Medicare Beneficiaries | 2233 |
| Total Submitted Charge Amount | 3079867 |
| Total Medicare Allowed Amount | 309899.85 |
| Total Medicare Payment Amount | 247539.47 |
| Total Medicare Standardized Payment Amount | 263300.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 10080 |
| Number Of Medicare Beneficiaries With Drug Services | 117 |
| Total Drug Submitted ChargeAmount | 21623 |
| Total Drug Medicare AllowedAmount | 2815.5 |
| Total Drug Medicare PaymentAmount | 2105.85 |
| Total Drug Medicare Standardized Payment Amount | 2105.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 178 |
| Number Of Medical Services | 3839 |
| Number Of Medicare Beneficiaries With Medical Services | 2232 |
| Total Medical Submitted Charge Amount | 3058244 |
| Total Medical Medicare Allowed Amount | 307084.35 |
| Total Medical Medicare Payment Amount | 245433.62 |
| Total Medical Medicare Standardized Payment Amount | 261194.63 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 384 |
| Number Of Beneficiaries Age 65 to 74 | 949 |
| Number Of Beneficiaries Age 75 to 84 | 608 |
| Number Of Beneficiaries Age Greater 84 | 292 |
| Number Of Female Beneficiaries | 1534 |
| Number Of Male Beneficiaries | 699 |
| Number Of Non Hispanic White Beneficiaries | 2119 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 35 |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1768 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 465 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2186 |