| National Provider Identifier [NPI]: | 1952457566 |
| Last Name Of The Provider | FITZGERALD |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 375 DIXMYTH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CINCINNATI |
| Zip Code Of The Provider | 452202475 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 150 |
| Number Of Services | 2781 |
| Number Of Medicare Beneficiaries | 2153 |
| Total Submitted Charge Amount | 295274.25 |
| Total Medicare Allowed Amount | 93139.89 |
| Total Medicare Payment Amount | 72128.07 |
| Total Medicare Standardized Payment Amount | 74326.08 |
| 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 | 150 |
| Number Of Medical Services | 2781 |
| Number Of Medicare Beneficiaries With Medical Services | 2153 |
| Total Medical Submitted Charge Amount | 295274.25 |
| Total Medical Medicare Allowed Amount | 93139.89 |
| Total Medical Medicare Payment Amount | 72128.07 |
| Total Medical Medicare Standardized Payment Amount | 74326.08 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 439 |
| Number Of Beneficiaries Age 65 to 74 | 814 |
| Number Of Beneficiaries Age 75 to 84 | 606 |
| Number Of Beneficiaries Age Greater 84 | 294 |
| Number Of Female Beneficiaries | 1314 |
| Number Of Male Beneficiaries | 839 |
| Number Of Non Hispanic White Beneficiaries | 1742 |
| Number Of Black or African American Beneficiaries | 343 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1665 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 488 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5275 |