| National Provider Identifier [NPI]: | 1174576938 |
| Last Name Of The Provider | ROTHSTEIN |
| First Name Of The Provider | MITCHELL |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 425 N LEE ST |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322041127 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 10993 |
| Number Of Medicare Beneficiaries | 1782 |
| Total Submitted Charge Amount | 876089.56 |
| Total Medicare Allowed Amount | 732067.27 |
| Total Medicare Payment Amount | 549826.72 |
| Total Medicare Standardized Payment Amount | 646682.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 2428 |
| Number Of Medicare Beneficiaries With Drug Services | 207 |
| Total Drug Submitted ChargeAmount | 9501 |
| Total Drug Medicare AllowedAmount | 6574.02 |
| Total Drug Medicare PaymentAmount | 6116.15 |
| Total Drug Medicare Standardized Payment Amount | 6116.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 8565 |
| Number Of Medicare Beneficiaries With Medical Services | 1782 |
| Total Medical Submitted Charge Amount | 866588.56 |
| Total Medical Medicare Allowed Amount | 725493.25 |
| Total Medical Medicare Payment Amount | 543710.57 |
| Total Medical Medicare Standardized Payment Amount | 640565.94 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 266 |
| Number Of Beneficiaries Age 65 to 74 | 949 |
| Number Of Beneficiaries Age 75 to 84 | 479 |
| Number Of Beneficiaries Age Greater 84 | 88 |
| Number Of Female Beneficiaries | 857 |
| Number Of Male Beneficiaries | 925 |
| Number Of Non Hispanic White Beneficiaries | 1464 |
| Number Of Black or African American Beneficiaries | 217 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1591 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 191 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3907 |