| National Provider Identifier [NPI]: | 1548212475 |
| Last Name Of The Provider | MITCHELL |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1086A BAXTER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ATHENS |
| Zip Code Of The Provider | 306066316 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 28775 |
| Number Of Medicare Beneficiaries | 1100 |
| Total Submitted Charge Amount | 1570843.5 |
| Total Medicare Allowed Amount | 520958.2 |
| Total Medicare Payment Amount | 384004.29 |
| Total Medicare Standardized Payment Amount | 410949.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 26160 |
| Number Of Medicare Beneficiaries With Drug Services | 67 |
| Total Drug Submitted ChargeAmount | 289131.5 |
| Total Drug Medicare AllowedAmount | 149377.22 |
| Total Drug Medicare PaymentAmount | 113905.02 |
| Total Drug Medicare Standardized Payment Amount | 113905.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 2615 |
| Number Of Medicare Beneficiaries With Medical Services | 1099 |
| Total Medical Submitted Charge Amount | 1281712 |
| Total Medical Medicare Allowed Amount | 371580.98 |
| Total Medical Medicare Payment Amount | 270099.27 |
| Total Medical Medicare Standardized Payment Amount | 297044.25 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 237 |
| Number Of Beneficiaries Age 65 to 74 | 411 |
| Number Of Beneficiaries Age 75 to 84 | 334 |
| Number Of Beneficiaries Age Greater 84 | 118 |
| Number Of Female Beneficiaries | 625 |
| Number Of Male Beneficiaries | 475 |
| Number Of Non Hispanic White Beneficiaries | 933 |
| Number Of Black or African American Beneficiaries | 139 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 851 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 249 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 24 |
| Average HCC Risk Score Of Beneficiaries | 1.454 |