| National Provider Identifier [NPI]: | 1053337709 |
| Last Name Of The Provider | EGBUCHUNAM |
| First Name Of The Provider | CHRISTIE |
| Middle Initial Of The Provider | U |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 305 REGENCY PKWY |
| Street Address 2 Of The Provider | SUITE 509 |
| City Of The Provider | MANSFIELD |
| Zip Code Of The Provider | 760633794 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 678 |
| Number Of Medicare Beneficiaries | 37 |
| Total Submitted Charge Amount | 69201.26 |
| Total Medicare Allowed Amount | 30201.08 |
| Total Medicare Payment Amount | 23533.17 |
| Total Medicare Standardized Payment Amount | 24298.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 33 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 1250 |
| Total Drug Medicare AllowedAmount | 517.91 |
| Total Drug Medicare PaymentAmount | 507.09 |
| Total Drug Medicare Standardized Payment Amount | 507.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 645 |
| Number Of Medicare Beneficiaries With Medical Services | 37 |
| Total Medical Submitted Charge Amount | 67951.26 |
| Total Medical Medicare Allowed Amount | 29683.17 |
| Total Medical Medicare Payment Amount | 23026.08 |
| Total Medical Medicare Standardized Payment Amount | 23791.04 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 21 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 25 |
| Number Of Male Beneficiaries | 12 |
| Number Of Non Hispanic White Beneficiaries | 21 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| 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 | |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9154 |