| National Provider Identifier [NPI]: | 1932361250 |
| Last Name Of The Provider | MITCHELL |
| First Name Of The Provider | TODD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7340 SHADELAND STA STE 200 |
| Street Address 2 Of The Provider | |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462563980 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 133 |
| Number Of Services | 4826 |
| Number Of Medicare Beneficiaries | 2865 |
| Total Submitted Charge Amount | 262096 |
| Total Medicare Allowed Amount | 107071.77 |
| Total Medicare Payment Amount | 87155.3 |
| Total Medicare Standardized Payment Amount | 91575.57 |
| 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 | 133 |
| Number Of Medical Services | 4826 |
| Number Of Medicare Beneficiaries With Medical Services | 2865 |
| Total Medical Submitted Charge Amount | 262096 |
| Total Medical Medicare Allowed Amount | 107071.77 |
| Total Medical Medicare Payment Amount | 87155.3 |
| Total Medical Medicare Standardized Payment Amount | 91575.57 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 523 |
| Number Of Beneficiaries Age 65 to 74 | 1268 |
| Number Of Beneficiaries Age 75 to 84 | 758 |
| Number Of Beneficiaries Age Greater 84 | 316 |
| Number Of Female Beneficiaries | 2283 |
| Number Of Male Beneficiaries | 582 |
| Number Of Non Hispanic White Beneficiaries | 2287 |
| Number Of Black or African American Beneficiaries | 482 |
| Number Of AsianPacific Islander Beneficiaries | 24 |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2235 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 630 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3177 |