| National Provider Identifier [NPI]: | 1457466963 |
| Last Name Of The Provider | MITZEL |
| First Name Of The Provider | SAMUEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | CRNA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3333 S WADSWORTH BLVD UNIT D100 |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAKEWOOD |
| Zip Code Of The Provider | 802275117 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | CRNA |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 3 |
| Number Of Services | 397 |
| Number Of Medicare Beneficiaries | 392 |
| Total Submitted Charge Amount | 409900 |
| Total Medicare Allowed Amount | 61258.91 |
| Total Medicare Payment Amount | 44359.84 |
| Total Medicare Standardized Payment Amount | 44788.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 3 |
| Number Of Medical Services | 397 |
| Number Of Medicare Beneficiaries With Medical Services | 392 |
| Total Medical Submitted Charge Amount | 409900 |
| Total Medical Medicare Allowed Amount | 61258.91 |
| Total Medical Medicare Payment Amount | 44359.84 |
| Total Medical Medicare Standardized Payment Amount | 44788.38 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 236 |
| Number Of Beneficiaries Age 75 to 84 | 104 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 217 |
| Number Of Male Beneficiaries | 175 |
| Number Of Non Hispanic White Beneficiaries | 333 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 339 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7533 |