| National Provider Identifier [NPI]: | 1922173616 |
| Last Name Of The Provider | MICKELSON |
| First Name Of The Provider | MORRIS |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1111 W FRANK AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | LUFKIN |
| Zip Code Of The Provider | 759043303 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 16830 |
| Number Of Medicare Beneficiaries | 519 |
| Total Submitted Charge Amount | 507440.45 |
| Total Medicare Allowed Amount | 503939.28 |
| Total Medicare Payment Amount | 383326.85 |
| Total Medicare Standardized Payment Amount | 388696.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 12204 |
| Number Of Medicare Beneficiaries With Drug Services | 308 |
| Total Drug Submitted ChargeAmount | 183885.41 |
| Total Drug Medicare AllowedAmount | 183599.69 |
| Total Drug Medicare PaymentAmount | 144992.64 |
| Total Drug Medicare Standardized Payment Amount | 144992.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 4626 |
| Number Of Medicare Beneficiaries With Medical Services | 519 |
| Total Medical Submitted Charge Amount | 323555.04 |
| Total Medical Medicare Allowed Amount | 320339.59 |
| Total Medical Medicare Payment Amount | 238334.21 |
| Total Medical Medicare Standardized Payment Amount | 243703.95 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 191 |
| Number Of Beneficiaries Age 75 to 84 | 186 |
| Number Of Beneficiaries Age Greater 84 | 116 |
| Number Of Female Beneficiaries | 301 |
| Number Of Male Beneficiaries | 218 |
| Number Of Non Hispanic White Beneficiaries | 496 |
| Number Of Black or African American Beneficiaries | |
| 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 | 490 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 37 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3704 |