| National Provider Identifier [NPI]: | 1447209606 |
| Last Name Of The Provider | MITTAL |
| First Name Of The Provider | SHALENDER |
| 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 | 519 N 6TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BLYTHEVILLE |
| Zip Code Of The Provider | 723152407 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 20159 |
| Number Of Medicare Beneficiaries | 625 |
| Total Submitted Charge Amount | 644641.3 |
| Total Medicare Allowed Amount | 555404.84 |
| Total Medicare Payment Amount | 428601.66 |
| Total Medicare Standardized Payment Amount | 470140.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 5745 |
| Number Of Medicare Beneficiaries With Drug Services | 503 |
| Total Drug Submitted ChargeAmount | 35642.3 |
| Total Drug Medicare AllowedAmount | 23457.4 |
| Total Drug Medicare PaymentAmount | 20850.99 |
| Total Drug Medicare Standardized Payment Amount | 20850.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 14414 |
| Number Of Medicare Beneficiaries With Medical Services | 625 |
| Total Medical Submitted Charge Amount | 608999 |
| Total Medical Medicare Allowed Amount | 531947.44 |
| Total Medical Medicare Payment Amount | 407750.67 |
| Total Medical Medicare Standardized Payment Amount | 449289.31 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 102 |
| Number Of Beneficiaries Age 65 to 74 | 212 |
| Number Of Beneficiaries Age 75 to 84 | 200 |
| Number Of Beneficiaries Age Greater 84 | 111 |
| Number Of Female Beneficiaries | 401 |
| Number Of Male Beneficiaries | 224 |
| Number Of Non Hispanic White Beneficiaries | 437 |
| 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 | 432 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 193 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1623 |