| National Provider Identifier [NPI]: | 1053349225 |
| Last Name Of The Provider | MITCHELL |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1023 MEDICAL CENTER PKWY |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | SELMA |
| Zip Code Of The Provider | 367016780 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 82 |
| Number Of Services | 2485 |
| Number Of Medicare Beneficiaries | 672 |
| Total Submitted Charge Amount | 155742.5 |
| Total Medicare Allowed Amount | 134544.83 |
| Total Medicare Payment Amount | 102013.44 |
| Total Medicare Standardized Payment Amount | 110205.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 440 |
| Number Of Medicare Beneficiaries With Drug Services | 172 |
| Total Drug Submitted ChargeAmount | 5041.5 |
| Total Drug Medicare AllowedAmount | 3242.71 |
| Total Drug Medicare PaymentAmount | 3108.42 |
| Total Drug Medicare Standardized Payment Amount | 3108.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 2045 |
| Number Of Medicare Beneficiaries With Medical Services | 672 |
| Total Medical Submitted Charge Amount | 150701 |
| Total Medical Medicare Allowed Amount | 131302.12 |
| Total Medical Medicare Payment Amount | 98905.02 |
| Total Medical Medicare Standardized Payment Amount | 107097.2 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 259 |
| Number Of Beneficiaries Age 65 to 74 | 204 |
| Number Of Beneficiaries Age 75 to 84 | 149 |
| Number Of Beneficiaries Age Greater 84 | 60 |
| Number Of Female Beneficiaries | 420 |
| Number Of Male Beneficiaries | 252 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 462 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 283 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 389 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5971 |