| National Provider Identifier [NPI]: | 1265695589 |
| Last Name Of The Provider | CHRISTIANSEN |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4327 BARNETT RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WICHITA FALLS |
| Zip Code Of The Provider | 763102303 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 6591 |
| Number Of Medicare Beneficiaries | 1238 |
| Total Submitted Charge Amount | 2328725.14 |
| Total Medicare Allowed Amount | 691876.44 |
| Total Medicare Payment Amount | 513568.57 |
| Total Medicare Standardized Payment Amount | 527833.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 101 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 44984.6 |
| Total Drug Medicare AllowedAmount | 12788.41 |
| Total Drug Medicare PaymentAmount | 9970.88 |
| Total Drug Medicare Standardized Payment Amount | 9970.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 6490 |
| Number Of Medicare Beneficiaries With Medical Services | 1238 |
| Total Medical Submitted Charge Amount | 2283740.54 |
| Total Medical Medicare Allowed Amount | 679088.03 |
| Total Medical Medicare Payment Amount | 503597.69 |
| Total Medical Medicare Standardized Payment Amount | 517863.09 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 95 |
| Number Of Beneficiaries Age 65 to 74 | 555 |
| Number Of Beneficiaries Age 75 to 84 | 415 |
| Number Of Beneficiaries Age Greater 84 | 173 |
| Number Of Female Beneficiaries | 699 |
| Number Of Male Beneficiaries | 539 |
| Number Of Non Hispanic White Beneficiaries | 1181 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1124 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 114 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0439 |