| National Provider Identifier [NPI]: | 1982805321 |
| Last Name Of The Provider | MAYFIELD |
| First Name Of The Provider | COREY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6451 BRENTWOOD STAIR RD. |
| Street Address 2 Of The Provider | #200 |
| City Of The Provider | FORT WORTH |
| Zip Code Of The Provider | 76112 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 811 |
| Number Of Medicare Beneficiaries | 713 |
| Total Submitted Charge Amount | 635164 |
| Total Medicare Allowed Amount | 105307.44 |
| Total Medicare Payment Amount | 80966.6 |
| Total Medicare Standardized Payment Amount | 82476.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 811 |
| Number Of Medicare Beneficiaries With Medical Services | 713 |
| Total Medical Submitted Charge Amount | 635164 |
| Total Medical Medicare Allowed Amount | 105307.44 |
| Total Medical Medicare Payment Amount | 80966.6 |
| Total Medical Medicare Standardized Payment Amount | 82476.61 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 186 |
| Number Of Beneficiaries Age 65 to 74 | 217 |
| Number Of Beneficiaries Age 75 to 84 | 186 |
| Number Of Beneficiaries Age Greater 84 | 124 |
| Number Of Female Beneficiaries | 435 |
| Number Of Male Beneficiaries | 278 |
| Number Of Non Hispanic White Beneficiaries | 524 |
| Number Of Black or African American Beneficiaries | 146 |
| 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 | 538 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 175 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.9045 |