| National Provider Identifier [NPI]: | 1225288038 |
| Last Name Of The Provider | EBERSOLE |
| First Name Of The Provider | CHRISTOPHER |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2116 CRAIG RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | EAU CLAIRE |
| Zip Code Of The Provider | 547016149 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 133 |
| Number Of Services | 5717 |
| Number Of Medicare Beneficiaries | 2577 |
| Total Submitted Charge Amount | 943074.86 |
| Total Medicare Allowed Amount | 128001.21 |
| Total Medicare Payment Amount | 93050.63 |
| Total Medicare Standardized Payment Amount | 98250.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1530 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 3492.6 |
| Total Drug Medicare AllowedAmount | 981.96 |
| Total Drug Medicare PaymentAmount | 768.43 |
| Total Drug Medicare Standardized Payment Amount | 768.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 128 |
| Number Of Medical Services | 4187 |
| Number Of Medicare Beneficiaries With Medical Services | 2574 |
| Total Medical Submitted Charge Amount | 939582.26 |
| Total Medical Medicare Allowed Amount | 127019.25 |
| Total Medical Medicare Payment Amount | 92282.2 |
| Total Medical Medicare Standardized Payment Amount | 97481.99 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 575 |
| Number Of Beneficiaries Age 65 to 74 | 1048 |
| Number Of Beneficiaries Age 75 to 84 | 668 |
| Number Of Beneficiaries Age Greater 84 | 286 |
| Number Of Female Beneficiaries | 1546 |
| Number Of Male Beneficiaries | 1031 |
| Number Of Non Hispanic White Beneficiaries | 2468 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 39 |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1800 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 777 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 1.3249 |