| National Provider Identifier [NPI]: | 1114124542 |
| Last Name Of The Provider | FISHER |
| First Name Of The Provider | SAMANTHA |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2235 VENETIAN COURT |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | NAPLES |
| Zip Code Of The Provider | 341098728 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 8886 |
| Number Of Medicare Beneficiaries | 1233 |
| Total Submitted Charge Amount | 575891.34 |
| Total Medicare Allowed Amount | 512619.81 |
| Total Medicare Payment Amount | 385697.64 |
| Total Medicare Standardized Payment Amount | 359251.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 182 |
| Number Of Medicare Beneficiaries With Drug Services | 72 |
| Total Drug Submitted ChargeAmount | 11177.5 |
| Total Drug Medicare AllowedAmount | 11079.7 |
| Total Drug Medicare PaymentAmount | 8544.8 |
| Total Drug Medicare Standardized Payment Amount | 8544.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 8704 |
| Number Of Medicare Beneficiaries With Medical Services | 1233 |
| Total Medical Submitted Charge Amount | 564713.84 |
| Total Medical Medicare Allowed Amount | 501540.11 |
| Total Medical Medicare Payment Amount | 377152.84 |
| Total Medical Medicare Standardized Payment Amount | 350706.71 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 523 |
| Number Of Beneficiaries Age 75 to 84 | 451 |
| Number Of Beneficiaries Age Greater 84 | 223 |
| Number Of Female Beneficiaries | 711 |
| Number Of Male Beneficiaries | 522 |
| Number Of Non Hispanic White Beneficiaries | 1190 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1212 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0452 |