| National Provider Identifier [NPI]: | 1972695021 |
| Last Name Of The Provider | MITCHELL |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11124 WURZBACH RD STE 300 |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782302445 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 6 |
| Number Of Services | 2117 |
| Number Of Medicare Beneficiaries | 586 |
| Total Submitted Charge Amount | 154335 |
| Total Medicare Allowed Amount | 142256.29 |
| Total Medicare Payment Amount | 95223.34 |
| Total Medicare Standardized Payment Amount | 106996.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 6 |
| Number Of Medical Services | 2117 |
| Number Of Medicare Beneficiaries With Medical Services | 586 |
| Total Medical Submitted Charge Amount | 154335 |
| Total Medical Medicare Allowed Amount | 142256.29 |
| Total Medical Medicare Payment Amount | 95223.34 |
| Total Medical Medicare Standardized Payment Amount | 106996.82 |
| Average Age Of Beneficiaries | 47 |
| Number Of Beneficiaries Age Less65 | 528 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 277 |
| Number Of Male Beneficiaries | 309 |
| Number Of Non Hispanic White Beneficiaries | 312 |
| Number Of Black or African American Beneficiaries | 52 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 208 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 2 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 31 |
| Percent Of With Ischemic Heart Disease | 5 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 10 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 30 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8324 |