| National Provider Identifier [NPI]: | 1396703997 |
| Last Name Of The Provider | FISHER |
| First Name Of The Provider | KATHY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4905 OLD ORCHARD CTR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SKOKIE |
| Zip Code Of The Provider | 600771425 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 485 |
| Number Of Medicare Beneficiaries | 86 |
| Total Submitted Charge Amount | 62612 |
| Total Medicare Allowed Amount | 24501.16 |
| Total Medicare Payment Amount | 18461.84 |
| Total Medicare Standardized Payment Amount | 17433.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 1546 |
| Total Drug Medicare AllowedAmount | 1299.25 |
| Total Drug Medicare PaymentAmount | 1273.17 |
| Total Drug Medicare Standardized Payment Amount | 1273.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 451 |
| Number Of Medicare Beneficiaries With Medical Services | 86 |
| Total Medical Submitted Charge Amount | 61066 |
| Total Medical Medicare Allowed Amount | 23201.91 |
| Total Medical Medicare Payment Amount | 17188.67 |
| Total Medical Medicare Standardized Payment Amount | 16160.58 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 46 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7512 |