| National Provider Identifier [NPI]: | 1972679918 |
| Last Name Of The Provider | FITZGERALD |
| First Name Of The Provider | KELLEEN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1100 JOHNSON FERRY RD. |
| Street Address 2 Of The Provider | BLDG. II, SUITE 460 |
| City Of The Provider | ATLANTA |
| Zip Code Of The Provider | 303421709 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 1952 |
| Number Of Medicare Beneficiaries | 393 |
| Total Submitted Charge Amount | 349871 |
| Total Medicare Allowed Amount | 122264.95 |
| Total Medicare Payment Amount | 94979.31 |
| Total Medicare Standardized Payment Amount | 94968.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 104 |
| Number Of Medicare Beneficiaries With Drug Services | 89 |
| Total Drug Submitted ChargeAmount | 18129 |
| Total Drug Medicare AllowedAmount | 4454.97 |
| Total Drug Medicare PaymentAmount | 4289.55 |
| Total Drug Medicare Standardized Payment Amount | 4289.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 1848 |
| Number Of Medicare Beneficiaries With Medical Services | 393 |
| Total Medical Submitted Charge Amount | 331742 |
| Total Medical Medicare Allowed Amount | 117809.98 |
| Total Medical Medicare Payment Amount | 90689.76 |
| Total Medical Medicare Standardized Payment Amount | 90678.91 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 209 |
| Number Of Beneficiaries Age 75 to 84 | 111 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 353 |
| Number Of Male Beneficiaries | 40 |
| Number Of Non Hispanic White Beneficiaries | 372 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| 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 | 7 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 37 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7829 |