National Provider Identifier [NPI]: |
1619170453 |
Last Name Of The Provider |
MITCHELL |
First Name Of The Provider |
KENT |
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 |
701 EAST I-20 |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
ARLINGTON |
Zip Code Of The Provider |
76018 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
3725 |
Number Of Medicare Beneficiaries |
486 |
Total Submitted Charge Amount |
910420 |
Total Medicare Allowed Amount |
271825.33 |
Total Medicare Payment Amount |
202776.08 |
Total Medicare Standardized Payment Amount |
206242.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
247 |
Number Of Medicare Beneficiaries With Drug Services |
83 |
Total Drug Submitted ChargeAmount |
13155 |
Total Drug Medicare AllowedAmount |
1327.03 |
Total Drug Medicare PaymentAmount |
1013.27 |
Total Drug Medicare Standardized Payment Amount |
1013.27 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
45 |
Number Of Medical Services |
3478 |
Number Of Medicare Beneficiaries With Medical Services |
486 |
Total Medical Submitted Charge Amount |
897265 |
Total Medical Medicare Allowed Amount |
270498.3 |
Total Medical Medicare Payment Amount |
201762.81 |
Total Medical Medicare Standardized Payment Amount |
205229.43 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
199 |
Number Of Beneficiaries Age 65 to 74 |
175 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
326 |
Number Of Male Beneficiaries |
160 |
Number Of Non Hispanic White Beneficiaries |
364 |
Number Of Black or African American Beneficiaries |
74 |
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 |
312 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
174 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.6398 |