| National Provider Identifier [NPI]: | 1043203045 |
| Last Name Of The Provider | MITCHELL |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 24755 CHAGRIN BLVD |
| Street Address 2 Of The Provider | SUITE 345 |
| City Of The Provider | BEACHWOOD |
| Zip Code Of The Provider | 441225682 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 6291 |
| Number Of Medicare Beneficiaries | 491 |
| Total Submitted Charge Amount | 1242221 |
| Total Medicare Allowed Amount | 1169322.89 |
| Total Medicare Payment Amount | 902901.12 |
| Total Medicare Standardized Payment Amount | 911066.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1908 |
| Number Of Medicare Beneficiaries With Drug Services | 82 |
| Total Drug Submitted ChargeAmount | 946546 |
| Total Drug Medicare AllowedAmount | 913422.62 |
| Total Drug Medicare PaymentAmount | 712550.2 |
| Total Drug Medicare Standardized Payment Amount | 712550.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 4383 |
| Number Of Medicare Beneficiaries With Medical Services | 491 |
| Total Medical Submitted Charge Amount | 295675 |
| Total Medical Medicare Allowed Amount | 255900.27 |
| Total Medical Medicare Payment Amount | 190350.92 |
| Total Medical Medicare Standardized Payment Amount | 198515.87 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 139 |
| Number Of Beneficiaries Age 75 to 84 | 156 |
| Number Of Beneficiaries Age Greater 84 | 174 |
| Number Of Female Beneficiaries | 310 |
| Number Of Male Beneficiaries | 181 |
| Number Of Non Hispanic White Beneficiaries | 424 |
| 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 | 443 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4474 |