| National Provider Identifier [NPI]: | 1790708303 |
| Last Name Of The Provider | MITCHELL |
| First Name Of The Provider | TONIA |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | C., FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 CLINIC DRIVE |
| Street Address 2 Of The Provider | CLAYPOOL HILL |
| City Of The Provider | RICHLANDS |
| Zip Code Of The Provider | 246411100 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 968 |
| Number Of Medicare Beneficiaries | 224 |
| Total Submitted Charge Amount | 95472 |
| Total Medicare Allowed Amount | 63910.8 |
| Total Medicare Payment Amount | 42531.17 |
| Total Medicare Standardized Payment Amount | 52777.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 116 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 2135 |
| Total Drug Medicare AllowedAmount | 1558.9 |
| Total Drug Medicare PaymentAmount | 1522.12 |
| Total Drug Medicare Standardized Payment Amount | 1522.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 852 |
| Number Of Medicare Beneficiaries With Medical Services | 224 |
| Total Medical Submitted Charge Amount | 93337 |
| Total Medical Medicare Allowed Amount | 62351.9 |
| Total Medical Medicare Payment Amount | 41009.05 |
| Total Medical Medicare Standardized Payment Amount | 51254.89 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 97 |
| Number Of Beneficiaries Age 65 to 74 | 81 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 123 |
| Number Of Male Beneficiaries | 101 |
| Number Of Non Hispanic White Beneficiaries | 213 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 115 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 109 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1156 |