| National Provider Identifier [NPI]: | 1972527877 |
| Last Name Of The Provider | MITCHELL |
| First Name Of The Provider | WILLIAM |
| 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 | 2180 MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WAILUKU |
| Zip Code Of The Provider | 967931666 |
| State Code Of The Provider | HI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 2142 |
| Number Of Medicare Beneficiaries | 541 |
| Total Submitted Charge Amount | 207355.25 |
| Total Medicare Allowed Amount | 180933.46 |
| Total Medicare Payment Amount | 126742.7 |
| Total Medicare Standardized Payment Amount | 122197.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 159 |
| Number Of Medicare Beneficiaries With Drug Services | 103 |
| Total Drug Submitted ChargeAmount | 3851.36 |
| Total Drug Medicare AllowedAmount | 3480.38 |
| Total Drug Medicare PaymentAmount | 3367.69 |
| Total Drug Medicare Standardized Payment Amount | 3367.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 1983 |
| Number Of Medicare Beneficiaries With Medical Services | 541 |
| Total Medical Submitted Charge Amount | 203503.89 |
| Total Medical Medicare Allowed Amount | 177453.08 |
| Total Medical Medicare Payment Amount | 123375.01 |
| Total Medical Medicare Standardized Payment Amount | 118829.48 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 248 |
| Number Of Beneficiaries Age 75 to 84 | 164 |
| Number Of Beneficiaries Age Greater 84 | 68 |
| Number Of Female Beneficiaries | 278 |
| Number Of Male Beneficiaries | 263 |
| Number Of Non Hispanic White Beneficiaries | 225 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 207 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 53 |
| Number Of Beneficiaries With Medicare Only Entitlement | 482 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2163 |