| National Provider Identifier [NPI]: | 1578649950 |
| Last Name Of The Provider | HALLSTROM |
| First Name Of The Provider | BRIDGETT |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 738 W NORTHWEST HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | BARRINGTON |
| Zip Code Of The Provider | 600102640 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 3366 |
| Number Of Medicare Beneficiaries | 818 |
| Total Submitted Charge Amount | 154969.95 |
| Total Medicare Allowed Amount | 125558 |
| Total Medicare Payment Amount | 89607.78 |
| Total Medicare Standardized Payment Amount | 97424.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 40 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 600 |
| Total Drug Medicare AllowedAmount | 71.27 |
| Total Drug Medicare PaymentAmount | 55.88 |
| Total Drug Medicare Standardized Payment Amount | 55.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 3326 |
| Number Of Medicare Beneficiaries With Medical Services | 818 |
| Total Medical Submitted Charge Amount | 154369.95 |
| Total Medical Medicare Allowed Amount | 125486.73 |
| Total Medical Medicare Payment Amount | 89551.9 |
| Total Medical Medicare Standardized Payment Amount | 97368.78 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 372 |
| Number Of Beneficiaries Age 75 to 84 | 306 |
| Number Of Beneficiaries Age Greater 84 | 128 |
| Number Of Female Beneficiaries | 466 |
| Number Of Male Beneficiaries | 352 |
| Number Of Non Hispanic White Beneficiaries | 801 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 803 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.841 |