| National Provider Identifier [NPI]: | 1447241864 |
| Last Name Of The Provider | MITCHELL |
| First Name Of The Provider | E |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 WILLIAM CARLS DR |
| Street Address 2 Of The Provider | RSC |
| City Of The Provider | COMMERCE TOWNSHIP |
| Zip Code Of The Provider | 483822201 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 1423 |
| Number Of Medicare Beneficiaries | 275 |
| Total Submitted Charge Amount | 458979 |
| Total Medicare Allowed Amount | 179079.01 |
| Total Medicare Payment Amount | 134620.56 |
| Total Medicare Standardized Payment Amount | 131188.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 272 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 71778 |
| Total Drug Medicare AllowedAmount | 29448.65 |
| Total Drug Medicare PaymentAmount | 22788.46 |
| Total Drug Medicare Standardized Payment Amount | 22788.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 1151 |
| Number Of Medicare Beneficiaries With Medical Services | 275 |
| Total Medical Submitted Charge Amount | 387201 |
| Total Medical Medicare Allowed Amount | 149630.36 |
| Total Medical Medicare Payment Amount | 111832.1 |
| Total Medical Medicare Standardized Payment Amount | 108400.12 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 132 |
| Number Of Beneficiaries Age 75 to 84 | 67 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 169 |
| Number Of Male Beneficiaries | 106 |
| Number Of Non Hispanic White Beneficiaries | 263 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 248 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1738 |