| National Provider Identifier [NPI]: | 1740258508 |
| Last Name Of The Provider | MITCHELL |
| First Name Of The Provider | GORDON |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2700 E 29TH STREET |
| Street Address 2 Of The Provider | SUITE 220 |
| City Of The Provider | BRYAN |
| Zip Code Of The Provider | 77802 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 9896 |
| Number Of Medicare Beneficiaries | 1947 |
| Total Submitted Charge Amount | 2346503 |
| Total Medicare Allowed Amount | 729750.18 |
| Total Medicare Payment Amount | 541003.62 |
| Total Medicare Standardized Payment Amount | 572033.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1532 |
| Number Of Medicare Beneficiaries With Drug Services | 132 |
| Total Drug Submitted ChargeAmount | 76184 |
| Total Drug Medicare AllowedAmount | 27964.18 |
| Total Drug Medicare PaymentAmount | 21745.82 |
| Total Drug Medicare Standardized Payment Amount | 21745.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 8364 |
| Number Of Medicare Beneficiaries With Medical Services | 1947 |
| Total Medical Submitted Charge Amount | 2270319 |
| Total Medical Medicare Allowed Amount | 701786 |
| Total Medical Medicare Payment Amount | 519257.8 |
| Total Medical Medicare Standardized Payment Amount | 550287.97 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 204 |
| Number Of Beneficiaries Age 65 to 74 | 618 |
| Number Of Beneficiaries Age 75 to 84 | 723 |
| Number Of Beneficiaries Age Greater 84 | 402 |
| Number Of Female Beneficiaries | 953 |
| Number Of Male Beneficiaries | 994 |
| Number Of Non Hispanic White Beneficiaries | 1566 |
| Number Of Black or African American Beneficiaries | 252 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 112 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1561 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 386 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6568 |