| National Provider Identifier [NPI]: | 1942314257 |
| Last Name Of The Provider | CHRISTENSEN |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 250 E MAPLE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW LENOX |
| Zip Code Of The Provider | 604511871 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 1276 |
| Number Of Medicare Beneficiaries | 486 |
| Total Submitted Charge Amount | 190885 |
| Total Medicare Allowed Amount | 114299.82 |
| Total Medicare Payment Amount | 81321.16 |
| Total Medicare Standardized Payment Amount | 76989.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 118 |
| Number Of Medicare Beneficiaries With Drug Services | 82 |
| Total Drug Submitted ChargeAmount | 4466 |
| Total Drug Medicare AllowedAmount | 3096.04 |
| Total Drug Medicare PaymentAmount | 2997.02 |
| Total Drug Medicare Standardized Payment Amount | 2997.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 1158 |
| Number Of Medicare Beneficiaries With Medical Services | 486 |
| Total Medical Submitted Charge Amount | 186419 |
| Total Medical Medicare Allowed Amount | 111203.78 |
| Total Medical Medicare Payment Amount | 78324.14 |
| Total Medical Medicare Standardized Payment Amount | 73992.05 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 261 |
| Number Of Beneficiaries Age 75 to 84 | 135 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 239 |
| Number Of Male Beneficiaries | 247 |
| Number Of Non Hispanic White Beneficiaries | 459 |
| Number Of Black or African American Beneficiaries | 14 |
| 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 | 454 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8512 |