| National Provider Identifier [NPI]: | 1417955766 |
| Last Name Of The Provider | PRESTON |
| First Name Of The Provider | MITCHELL |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1021 E BRYAN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAPULPA |
| Zip Code Of The Provider | 740664512 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 2056 |
| Number Of Medicare Beneficiaries | 367 |
| Total Submitted Charge Amount | 201569 |
| Total Medicare Allowed Amount | 95804.9 |
| Total Medicare Payment Amount | 62632.25 |
| Total Medicare Standardized Payment Amount | 70200.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 204 |
| Number Of Medicare Beneficiaries With Drug Services | 104 |
| Total Drug Submitted ChargeAmount | 5579 |
| Total Drug Medicare AllowedAmount | 3013.14 |
| Total Drug Medicare PaymentAmount | 2863.05 |
| Total Drug Medicare Standardized Payment Amount | 2863.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 1852 |
| Number Of Medicare Beneficiaries With Medical Services | 367 |
| Total Medical Submitted Charge Amount | 195990 |
| Total Medical Medicare Allowed Amount | 92791.76 |
| Total Medical Medicare Payment Amount | 59769.2 |
| Total Medical Medicare Standardized Payment Amount | 67336.97 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 80 |
| Number Of Beneficiaries Age 65 to 74 | 142 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | 52 |
| Number Of Female Beneficiaries | 191 |
| Number Of Male Beneficiaries | 176 |
| Number Of Non Hispanic White Beneficiaries | 334 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 19 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 268 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 99 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 31 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2407 |