| National Provider Identifier [NPI]: | 1457490955 |
| Last Name Of The Provider | MIZELLE |
| First Name Of The Provider | KRISTI |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 704 THIMBLE SHOALS BLVD |
| Street Address 2 Of The Provider | BLDG. 300 A |
| City Of The Provider | NEWPORT NEWS |
| Zip Code Of The Provider | 236064544 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 25769 |
| Number Of Medicare Beneficiaries | 568 |
| Total Submitted Charge Amount | 1894737.9 |
| Total Medicare Allowed Amount | 949797.27 |
| Total Medicare Payment Amount | 726638.7 |
| Total Medicare Standardized Payment Amount | 730902.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 22250 |
| Number Of Medicare Beneficiaries With Drug Services | 235 |
| Total Drug Submitted ChargeAmount | 1329740.9 |
| Total Drug Medicare AllowedAmount | 725496.63 |
| Total Drug Medicare PaymentAmount | 560207.29 |
| Total Drug Medicare Standardized Payment Amount | 560207.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 3519 |
| Number Of Medicare Beneficiaries With Medical Services | 568 |
| Total Medical Submitted Charge Amount | 564997 |
| Total Medical Medicare Allowed Amount | 224300.64 |
| Total Medical Medicare Payment Amount | 166431.41 |
| Total Medical Medicare Standardized Payment Amount | 170694.8 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 262 |
| Number Of Beneficiaries Age 75 to 84 | 191 |
| Number Of Beneficiaries Age Greater 84 | 66 |
| Number Of Female Beneficiaries | 453 |
| Number Of Male Beneficiaries | 115 |
| Number Of Non Hispanic White Beneficiaries | 438 |
| Number Of Black or African American Beneficiaries | 107 |
| 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 | 539 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 39 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1435 |