| National Provider Identifier [NPI]: | 1629074752 |
| Last Name Of The Provider | KRZYSTOLIK |
| First Name Of The Provider | MAGDALENA |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 RANDALL SQ |
| Street Address 2 Of The Provider | SUITE 203 |
| City Of The Provider | PROVIDENCE |
| Zip Code Of The Provider | 029042709 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 10840 |
| Number Of Medicare Beneficiaries | 1073 |
| Total Submitted Charge Amount | 4320012 |
| Total Medicare Allowed Amount | 2758192.5 |
| Total Medicare Payment Amount | 2133260.48 |
| Total Medicare Standardized Payment Amount | 2106215.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 4898 |
| Number Of Medicare Beneficiaries With Drug Services | 256 |
| Total Drug Submitted ChargeAmount | 2925987 |
| Total Drug Medicare AllowedAmount | 2163048.46 |
| Total Drug Medicare PaymentAmount | 1687745.99 |
| Total Drug Medicare Standardized Payment Amount | 1687745.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 5942 |
| Number Of Medicare Beneficiaries With Medical Services | 1073 |
| Total Medical Submitted Charge Amount | 1394025 |
| Total Medical Medicare Allowed Amount | 595144.04 |
| Total Medical Medicare Payment Amount | 445514.49 |
| Total Medical Medicare Standardized Payment Amount | 418469.95 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 365 |
| Number Of Beneficiaries Age 75 to 84 | 364 |
| Number Of Beneficiaries Age Greater 84 | 273 |
| Number Of Female Beneficiaries | 662 |
| Number Of Male Beneficiaries | 411 |
| Number Of Non Hispanic White Beneficiaries | 999 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 875 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 198 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4128 |