| National Provider Identifier [NPI]: | 1427249614 |
| Last Name Of The Provider | MICHELL |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5742 SPOHN DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CORPUS CHRISTI |
| Zip Code Of The Provider | 784144116 |
| 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 | 136 |
| Number Of Services | 12774 |
| Number Of Medicare Beneficiaries | 3317 |
| Total Submitted Charge Amount | 890181.96 |
| Total Medicare Allowed Amount | 418851.29 |
| Total Medicare Payment Amount | 351476.66 |
| Total Medicare Standardized Payment Amount | 381187.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 6501 |
| Number Of Medicare Beneficiaries With Drug Services | 84 |
| Total Drug Submitted ChargeAmount | 4370.96 |
| Total Drug Medicare AllowedAmount | 1748.11 |
| Total Drug Medicare PaymentAmount | 1345.6 |
| Total Drug Medicare Standardized Payment Amount | 1345.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 133 |
| Number Of Medical Services | 6273 |
| Number Of Medicare Beneficiaries With Medical Services | 3317 |
| Total Medical Submitted Charge Amount | 885811 |
| Total Medical Medicare Allowed Amount | 417103.18 |
| Total Medical Medicare Payment Amount | 350131.06 |
| Total Medical Medicare Standardized Payment Amount | 379841.96 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 512 |
| Number Of Beneficiaries Age 65 to 74 | 1520 |
| Number Of Beneficiaries Age 75 to 84 | 943 |
| Number Of Beneficiaries Age Greater 84 | 342 |
| Number Of Female Beneficiaries | 2695 |
| Number Of Male Beneficiaries | 622 |
| Number Of Non Hispanic White Beneficiaries | 2058 |
| Number Of Black or African American Beneficiaries | 74 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 1143 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2581 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 736 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3965 |