| National Provider Identifier [NPI]: | 1033392774 |
| Last Name Of The Provider | POWELL |
| First Name Of The Provider | MICHELE |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7781 N POINT BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WINSTON SALEM |
| Zip Code Of The Provider | 271063309 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 1896.5 |
| Number Of Medicare Beneficiaries | 131 |
| Total Submitted Charge Amount | 224751 |
| Total Medicare Allowed Amount | 86864.76 |
| Total Medicare Payment Amount | 63209.32 |
| Total Medicare Standardized Payment Amount | 66001.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 492.5 |
| Number Of Medicare Beneficiaries With Drug Services | 57 |
| Total Drug Submitted ChargeAmount | 8491 |
| Total Drug Medicare AllowedAmount | 951.66 |
| Total Drug Medicare PaymentAmount | 784.65 |
| Total Drug Medicare Standardized Payment Amount | 784.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 1404 |
| Number Of Medicare Beneficiaries With Medical Services | 131 |
| Total Medical Submitted Charge Amount | 216260 |
| Total Medical Medicare Allowed Amount | 85913.1 |
| Total Medical Medicare Payment Amount | 62424.67 |
| Total Medical Medicare Standardized Payment Amount | 65217.05 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 54 |
| Number Of Beneficiaries Age 75 to 84 | 24 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 102 |
| Number Of Male Beneficiaries | 29 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 67 |
| 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 | 91 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9844 |