| National Provider Identifier [NPI]: | 1194737833 |
| Last Name Of The Provider | MITCHELL |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 160 ALLEN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | RUTLAND |
| Zip Code Of The Provider | 057014560 |
| State Code Of The Provider | VT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 221 |
| Number Of Services | 6526 |
| Number Of Medicare Beneficiaries | 3599 |
| Total Submitted Charge Amount | 949325.96 |
| Total Medicare Allowed Amount | 212464.36 |
| Total Medicare Payment Amount | 155828.32 |
| Total Medicare Standardized Payment Amount | 158213.44 |
| 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 | 221 |
| Number Of Medical Services | 6526 |
| Number Of Medicare Beneficiaries With Medical Services | 3599 |
| Total Medical Submitted Charge Amount | 949325.96 |
| Total Medical Medicare Allowed Amount | 212464.36 |
| Total Medical Medicare Payment Amount | 155828.32 |
| Total Medical Medicare Standardized Payment Amount | 158213.44 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 691 |
| Number Of Beneficiaries Age 65 to 74 | 1341 |
| Number Of Beneficiaries Age 75 to 84 | 1048 |
| Number Of Beneficiaries Age Greater 84 | 519 |
| Number Of Female Beneficiaries | 2332 |
| Number Of Male Beneficiaries | 1267 |
| Number Of Non Hispanic White Beneficiaries | 3523 |
| Number Of Black or African American Beneficiaries | 13 |
| 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 | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2434 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1165 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3354 |