| National Provider Identifier [NPI]: | 1154461416 |
| Last Name Of The Provider | MIST |
| First Name Of The Provider | HEIDI |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD, MPH&TM |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1022 JEFFERSON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | RED BLUFF |
| Zip Code Of The Provider | 960802726 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 3874 |
| Number Of Medicare Beneficiaries | 521 |
| Total Submitted Charge Amount | 297698 |
| Total Medicare Allowed Amount | 254594.89 |
| Total Medicare Payment Amount | 181207.64 |
| Total Medicare Standardized Payment Amount | 174991.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 362 |
| Number Of Medicare Beneficiaries With Drug Services | 271 |
| Total Drug Submitted ChargeAmount | 12680 |
| Total Drug Medicare AllowedAmount | 11159.74 |
| Total Drug Medicare PaymentAmount | 10864.34 |
| Total Drug Medicare Standardized Payment Amount | 10864.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 3512 |
| Number Of Medicare Beneficiaries With Medical Services | 521 |
| Total Medical Submitted Charge Amount | 285018 |
| Total Medical Medicare Allowed Amount | 243435.15 |
| Total Medical Medicare Payment Amount | 170343.3 |
| Total Medical Medicare Standardized Payment Amount | 164127.15 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 254 |
| Number Of Beneficiaries Age 75 to 84 | 147 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 358 |
| Number Of Male Beneficiaries | 163 |
| Number Of Non Hispanic White Beneficiaries | 502 |
| 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 | 467 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 2 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8198 |