| National Provider Identifier [NPI]: | 1861669517 |
| Last Name Of The Provider | MITCHELL |
| First Name Of The Provider | DAVIN |
| 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 | 1555 DOCTORS DR |
| Street Address 2 Of The Provider | SUITE 106 |
| City Of The Provider | LAGRANGE |
| Zip Code Of The Provider | 302404132 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 9612 |
| Number Of Medicare Beneficiaries | 575 |
| Total Submitted Charge Amount | 3503782.47 |
| Total Medicare Allowed Amount | 786451.03 |
| Total Medicare Payment Amount | 574413.86 |
| Total Medicare Standardized Payment Amount | 610365.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1313 |
| Number Of Medicare Beneficiaries With Drug Services | 352 |
| Total Drug Submitted ChargeAmount | 18759.93 |
| Total Drug Medicare AllowedAmount | 4272.9 |
| Total Drug Medicare PaymentAmount | 3095.99 |
| Total Drug Medicare Standardized Payment Amount | 3095.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 8299 |
| Number Of Medicare Beneficiaries With Medical Services | 575 |
| Total Medical Submitted Charge Amount | 3485022.54 |
| Total Medical Medicare Allowed Amount | 782178.13 |
| Total Medical Medicare Payment Amount | 571317.87 |
| Total Medical Medicare Standardized Payment Amount | 607269.06 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 330 |
| Number Of Beneficiaries Age 65 to 74 | 136 |
| Number Of Beneficiaries Age 75 to 84 | 85 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 341 |
| Number Of Male Beneficiaries | 234 |
| Number Of Non Hispanic White Beneficiaries | 436 |
| Number Of Black or African American Beneficiaries | 127 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 340 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 235 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.523 |