| National Provider Identifier [NPI]: | 1568415743 |
| Last Name Of The Provider | FITZGIBBONS |
| First Name Of The Provider | PATRICK |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 E VALENCIA MESA DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | FULLERTON |
| Zip Code Of The Provider | 928353809 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 2030 |
| Number Of Medicare Beneficiaries | 899 |
| Total Submitted Charge Amount | 339947 |
| Total Medicare Allowed Amount | 101085.24 |
| Total Medicare Payment Amount | 78938.05 |
| Total Medicare Standardized Payment Amount | 57245.69 |
| 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 | 27 |
| Number Of Medical Services | 2030 |
| Number Of Medicare Beneficiaries With Medical Services | 899 |
| Total Medical Submitted Charge Amount | 339947 |
| Total Medical Medicare Allowed Amount | 101085.24 |
| Total Medical Medicare Payment Amount | 78938.05 |
| Total Medical Medicare Standardized Payment Amount | 57245.69 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 384 |
| Number Of Beneficiaries Age 75 to 84 | 300 |
| Number Of Beneficiaries Age Greater 84 | 155 |
| Number Of Female Beneficiaries | 510 |
| Number Of Male Beneficiaries | 389 |
| Number Of Non Hispanic White Beneficiaries | 700 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | 85 |
| Number Of Hispanic Beneficiaries | 86 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 771 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 128 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3689 |