| National Provider Identifier [NPI]: | 1760590178 |
| Last Name Of The Provider | FISCH |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | OD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5455 SHERIDAN ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | KENOSHA |
| Zip Code Of The Provider | 53140 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 6213 |
| Number Of Medicare Beneficiaries | 556 |
| Total Submitted Charge Amount | 609745 |
| Total Medicare Allowed Amount | 279979.98 |
| Total Medicare Payment Amount | 212017.06 |
| Total Medicare Standardized Payment Amount | 207026.59 |
| 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 | 21 |
| Number Of Medical Services | 6213 |
| Number Of Medicare Beneficiaries With Medical Services | 556 |
| Total Medical Submitted Charge Amount | 609745 |
| Total Medical Medicare Allowed Amount | 279979.98 |
| Total Medical Medicare Payment Amount | 212017.06 |
| Total Medical Medicare Standardized Payment Amount | 207026.59 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 116 |
| Number Of Beneficiaries Age 65 to 74 | 90 |
| Number Of Beneficiaries Age 75 to 84 | 148 |
| Number Of Beneficiaries Age Greater 84 | 202 |
| Number Of Female Beneficiaries | 315 |
| Number Of Male Beneficiaries | 241 |
| Number Of Non Hispanic White Beneficiaries | 423 |
| Number Of Black or African American Beneficiaries | 85 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| 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 | 52 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 504 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 70 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 58 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 31 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.0658 |