| National Provider Identifier [NPI]: | 1063638914 |
| Last Name Of The Provider | MITCHELL |
| First Name Of The Provider | BRYAN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 560 W MACPHAIL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEL AIR |
| Zip Code Of The Provider | 210144320 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 2188 |
| Number Of Medicare Beneficiaries | 771 |
| Total Submitted Charge Amount | 218418.12 |
| Total Medicare Allowed Amount | 91275.91 |
| Total Medicare Payment Amount | 65288.04 |
| Total Medicare Standardized Payment Amount | 74380.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 234 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 2192.12 |
| Total Drug Medicare AllowedAmount | 677.24 |
| Total Drug Medicare PaymentAmount | 603.93 |
| Total Drug Medicare Standardized Payment Amount | 603.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 1954 |
| Number Of Medicare Beneficiaries With Medical Services | 771 |
| Total Medical Submitted Charge Amount | 216226 |
| Total Medical Medicare Allowed Amount | 90598.67 |
| Total Medical Medicare Payment Amount | 64684.11 |
| Total Medical Medicare Standardized Payment Amount | 73776.69 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 406 |
| Number Of Beneficiaries Age 75 to 84 | 213 |
| Number Of Beneficiaries Age Greater 84 | 87 |
| Number Of Female Beneficiaries | 475 |
| Number Of Male Beneficiaries | 296 |
| Number Of Non Hispanic White Beneficiaries | 708 |
| Number Of Black or African American Beneficiaries | 39 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 724 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9954 |