| National Provider Identifier [NPI]: | 1881642650 |
| Last Name Of The Provider | CHECKVER |
| First Name Of The Provider | MITCHELL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7211 N DALE MABRY HWY |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336142669 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 8 |
| Number Of Services | 765 |
| Number Of Medicare Beneficiaries | 108 |
| Total Submitted Charge Amount | 54845 |
| Total Medicare Allowed Amount | 51540.54 |
| Total Medicare Payment Amount | 34954.78 |
| Total Medicare Standardized Payment Amount | 38541.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 25 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 750 |
| Total Drug Medicare AllowedAmount | 274.28 |
| Total Drug Medicare PaymentAmount | 264.62 |
| Total Drug Medicare Standardized Payment Amount | 264.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 6 |
| Number Of Medical Services | 740 |
| Number Of Medicare Beneficiaries With Medical Services | 108 |
| Total Medical Submitted Charge Amount | 54095 |
| Total Medical Medicare Allowed Amount | 51266.26 |
| Total Medical Medicare Payment Amount | 34690.16 |
| Total Medical Medicare Standardized Payment Amount | 38276.7 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 45 |
| Number Of Beneficiaries Age 75 to 84 | 30 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 52 |
| Number Of Male Beneficiaries | 56 |
| Number Of Non Hispanic White Beneficiaries | 95 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 91 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9983 |