| National Provider Identifier [NPI]: | 1093767709 |
| Last Name Of The Provider | MITCHELL |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 204 ANA DRIVE |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | FLORENCE |
| Zip Code Of The Provider | 35630 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 10802 |
| Number Of Medicare Beneficiaries | 452 |
| Total Submitted Charge Amount | 433909.3 |
| Total Medicare Allowed Amount | 257425.84 |
| Total Medicare Payment Amount | 193779.16 |
| Total Medicare Standardized Payment Amount | 207955.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 2692 |
| Number Of Medicare Beneficiaries With Drug Services | 318 |
| Total Drug Submitted ChargeAmount | 39017.3 |
| Total Drug Medicare AllowedAmount | 20809.49 |
| Total Drug Medicare PaymentAmount | 17753.81 |
| Total Drug Medicare Standardized Payment Amount | 17753.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 8110 |
| Number Of Medicare Beneficiaries With Medical Services | 452 |
| Total Medical Submitted Charge Amount | 394892 |
| Total Medical Medicare Allowed Amount | 236616.35 |
| Total Medical Medicare Payment Amount | 176025.35 |
| Total Medical Medicare Standardized Payment Amount | 190201.75 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 185 |
| Number Of Beneficiaries Age 75 to 84 | 157 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 277 |
| Number Of Male Beneficiaries | 175 |
| Number Of Non Hispanic White Beneficiaries | 432 |
| Number Of Black or African American Beneficiaries | |
| 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 | 418 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0628 |