National Provider Identifier [NPI]: |
1518954320 |
Last Name Of The Provider |
FISHER |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3501 WE KNIGHT DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT SMITH |
Zip Code Of The Provider |
72903 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
2771 |
Number Of Medicare Beneficiaries |
535 |
Total Submitted Charge Amount |
609378 |
Total Medicare Allowed Amount |
145934.43 |
Total Medicare Payment Amount |
105423.16 |
Total Medicare Standardized Payment Amount |
112358.57 |
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 |
28 |
Number Of Medical Services |
2771 |
Number Of Medicare Beneficiaries With Medical Services |
535 |
Total Medical Submitted Charge Amount |
609378 |
Total Medical Medicare Allowed Amount |
145934.43 |
Total Medical Medicare Payment Amount |
105423.16 |
Total Medical Medicare Standardized Payment Amount |
112358.57 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
108 |
Number Of Beneficiaries Age 65 to 74 |
205 |
Number Of Beneficiaries Age 75 to 84 |
165 |
Number Of Beneficiaries Age Greater 84 |
57 |
Number Of Female Beneficiaries |
339 |
Number Of Male Beneficiaries |
196 |
Number Of Non Hispanic White Beneficiaries |
481 |
Number Of Black or African American Beneficiaries |
17 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
26 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
414 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
121 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1608 |