| National Provider Identifier [NPI]: | 1558350520 |
| Last Name Of The Provider | HAZLEWOOD |
| First Name Of The Provider | KRISTI |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | RN, MSN, CPNP,CFNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1100 MIDDLE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MILAN |
| Zip Code Of The Provider | 383585544 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 136 |
| Number Of Medicare Beneficiaries | 42 |
| Total Submitted Charge Amount | 13000 |
| Total Medicare Allowed Amount | 4429.98 |
| Total Medicare Payment Amount | 3095.41 |
| Total Medicare Standardized Payment Amount | 4001.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 71 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 507 |
| Total Drug Medicare AllowedAmount | 140.11 |
| Total Drug Medicare PaymentAmount | 112.15 |
| Total Drug Medicare Standardized Payment Amount | 112.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 65 |
| Number Of Medicare Beneficiaries With Medical Services | 41 |
| Total Medical Submitted Charge Amount | 12493 |
| Total Medical Medicare Allowed Amount | 4289.87 |
| Total Medical Medicare Payment Amount | 2983.26 |
| Total Medical Medicare Standardized Payment Amount | 3889.22 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 18 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 31 |
| Number Of Male Beneficiaries | 11 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 23 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 19 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.298 |