| National Provider Identifier [NPI]: | 1396747234 |
| Last Name Of The Provider | MITCHELL |
| First Name Of The Provider | SHARON |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1209 10TH ST |
| Street Address 2 Of The Provider | SUITE E |
| City Of The Provider | PORT HURON |
| Zip Code Of The Provider | 480605262 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 140 |
| Number Of Services | 5902 |
| Number Of Medicare Beneficiaries | 442 |
| Total Submitted Charge Amount | 364019.35 |
| Total Medicare Allowed Amount | 236496.62 |
| Total Medicare Payment Amount | 176352.55 |
| Total Medicare Standardized Payment Amount | 187168.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 700 |
| Number Of Medicare Beneficiaries With Drug Services | 163 |
| Total Drug Submitted ChargeAmount | 10588.45 |
| Total Drug Medicare AllowedAmount | 5078.36 |
| Total Drug Medicare PaymentAmount | 4438.83 |
| Total Drug Medicare Standardized Payment Amount | 4438.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 126 |
| Number Of Medical Services | 5202 |
| Number Of Medicare Beneficiaries With Medical Services | 442 |
| Total Medical Submitted Charge Amount | 353430.9 |
| Total Medical Medicare Allowed Amount | 231418.26 |
| Total Medical Medicare Payment Amount | 171913.72 |
| Total Medical Medicare Standardized Payment Amount | 182729.34 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 144 |
| Number Of Beneficiaries Age 65 to 74 | 181 |
| Number Of Beneficiaries Age 75 to 84 | 89 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 302 |
| Number Of Male Beneficiaries | 140 |
| Number Of Non Hispanic White Beneficiaries | 402 |
| Number Of Black or African American Beneficiaries | 19 |
| 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 | 329 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 113 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1447 |