| National Provider Identifier [NPI]: | 1700037751 |
| Last Name Of The Provider | MITCHELL |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3691 CRESCENT CT E |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | WHITEHALL |
| Zip Code Of The Provider | 180523433 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 577 |
| Number Of Medicare Beneficiaries | 188 |
| Total Submitted Charge Amount | 90415 |
| Total Medicare Allowed Amount | 46403.76 |
| Total Medicare Payment Amount | 31770.24 |
| Total Medicare Standardized Payment Amount | 33452.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 68 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 2530 |
| Total Drug Medicare AllowedAmount | 1716.47 |
| Total Drug Medicare PaymentAmount | 1666.38 |
| Total Drug Medicare Standardized Payment Amount | 1666.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 509 |
| Number Of Medicare Beneficiaries With Medical Services | 188 |
| Total Medical Submitted Charge Amount | 87885 |
| Total Medical Medicare Allowed Amount | 44687.29 |
| Total Medical Medicare Payment Amount | 30103.86 |
| Total Medical Medicare Standardized Payment Amount | 31785.79 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 53 |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | 59 |
| Number Of Female Beneficiaries | 127 |
| Number Of Male Beneficiaries | 61 |
| Number Of Non Hispanic White Beneficiaries | 171 |
| 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 | 159 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3021 |