| National Provider Identifier [NPI]: | 1477528636 |
| Last Name Of The Provider | MITCHELL |
| First Name Of The Provider | DAVID |
| 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 | 311 CAMDEN ST |
| Street Address 2 Of The Provider | SUITE 208 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782152012 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 150 |
| Number Of Services | 14801 |
| Number Of Medicare Beneficiaries | 2342 |
| Total Submitted Charge Amount | 1121276.85 |
| Total Medicare Allowed Amount | 290691.05 |
| Total Medicare Payment Amount | 219431.21 |
| Total Medicare Standardized Payment Amount | 239875.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 11431 |
| Number Of Medicare Beneficiaries With Drug Services | 201 |
| Total Drug Submitted ChargeAmount | 18160.85 |
| Total Drug Medicare AllowedAmount | 5224.33 |
| Total Drug Medicare PaymentAmount | 3688.6 |
| Total Drug Medicare Standardized Payment Amount | 3688.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 147 |
| Number Of Medical Services | 3370 |
| Number Of Medicare Beneficiaries With Medical Services | 2342 |
| Total Medical Submitted Charge Amount | 1103116 |
| Total Medical Medicare Allowed Amount | 285466.72 |
| Total Medical Medicare Payment Amount | 215742.61 |
| Total Medical Medicare Standardized Payment Amount | 236187.3 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 576 |
| Number Of Beneficiaries Age 65 to 74 | 972 |
| Number Of Beneficiaries Age 75 to 84 | 545 |
| Number Of Beneficiaries Age Greater 84 | 249 |
| Number Of Female Beneficiaries | 1491 |
| Number Of Male Beneficiaries | 851 |
| Number Of Non Hispanic White Beneficiaries | 1130 |
| Number Of Black or African American Beneficiaries | 213 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 942 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1670 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 672 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.87 |