| National Provider Identifier [NPI]: | 1003844903 |
| Last Name Of The Provider | MITCHELL |
| First Name Of The Provider | PENNY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1224 COMMERCE STREET SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | CONOVER |
| Zip Code Of The Provider | 28613 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 3473 |
| Number Of Medicare Beneficiaries | 464 |
| Total Submitted Charge Amount | 859026.35 |
| Total Medicare Allowed Amount | 170866.51 |
| Total Medicare Payment Amount | 120073.88 |
| Total Medicare Standardized Payment Amount | 152733.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 420 |
| Number Of Medicare Beneficiaries With Drug Services | 82 |
| Total Drug Submitted ChargeAmount | 8976 |
| Total Drug Medicare AllowedAmount | 684.9 |
| Total Drug Medicare PaymentAmount | 459.79 |
| Total Drug Medicare Standardized Payment Amount | 459.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 3053 |
| Number Of Medicare Beneficiaries With Medical Services | 464 |
| Total Medical Submitted Charge Amount | 850050.35 |
| Total Medical Medicare Allowed Amount | 170181.61 |
| Total Medical Medicare Payment Amount | 119614.09 |
| Total Medical Medicare Standardized Payment Amount | 152273.59 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 294 |
| Number Of Beneficiaries Age 65 to 74 | 119 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 299 |
| Number Of Male Beneficiaries | 165 |
| Number Of Non Hispanic White Beneficiaries | 422 |
| Number Of Black or African American Beneficiaries | 30 |
| 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 | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 217 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 247 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1511 |