| National Provider Identifier [NPI]: | 1245279546 |
| Last Name Of The Provider | MITROSKY |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1008 S 5TH AVE |
| Street Address 2 Of The Provider | SUITE 104 |
| City Of The Provider | CLARION |
| Zip Code Of The Provider | 162148676 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 1193 |
| Number Of Medicare Beneficiaries | 312 |
| Total Submitted Charge Amount | 184679 |
| Total Medicare Allowed Amount | 92343.53 |
| Total Medicare Payment Amount | 64577.01 |
| Total Medicare Standardized Payment Amount | 68059.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 126 |
| Number Of Medicare Beneficiaries With Drug Services | 90 |
| Total Drug Submitted ChargeAmount | 5128 |
| Total Drug Medicare AllowedAmount | 3985.04 |
| Total Drug Medicare PaymentAmount | 3897.87 |
| Total Drug Medicare Standardized Payment Amount | 3897.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 1067 |
| Number Of Medicare Beneficiaries With Medical Services | 312 |
| Total Medical Submitted Charge Amount | 179551 |
| Total Medical Medicare Allowed Amount | 88358.49 |
| Total Medical Medicare Payment Amount | 60679.14 |
| Total Medical Medicare Standardized Payment Amount | 64161.26 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 103 |
| Number Of Beneficiaries Age 65 to 74 | 106 |
| Number Of Beneficiaries Age 75 to 84 | 66 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 159 |
| Number Of Male Beneficiaries | 153 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 208 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5332 |