| National Provider Identifier [NPI]: | 1912958224 |
| Last Name Of The Provider | SOUTENDIJK |
| First Name Of The Provider | CHRISTINE |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 211 S 9TH ST |
| Street Address 2 Of The Provider | WALNUT TOWERS, SUITE 401 |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191076810 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 267 |
| Number Of Medicare Beneficiaries | 54 |
| Total Submitted Charge Amount | 37462 |
| Total Medicare Allowed Amount | 21921.7 |
| Total Medicare Payment Amount | 16759.22 |
| Total Medicare Standardized Payment Amount | 15880.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 1650 |
| Total Drug Medicare AllowedAmount | 759.12 |
| Total Drug Medicare PaymentAmount | 744.01 |
| Total Drug Medicare Standardized Payment Amount | 744.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 238 |
| Number Of Medicare Beneficiaries With Medical Services | 54 |
| Total Medical Submitted Charge Amount | 35812 |
| Total Medical Medicare Allowed Amount | 21162.58 |
| Total Medical Medicare Payment Amount | 16015.21 |
| Total Medical Medicare Standardized Payment Amount | 15136.56 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 33 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 29 |
| 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 | 40 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| 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 | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0326 |