| National Provider Identifier [NPI]: | 1538173950 |
| Last Name Of The Provider | CHISHOLM |
| First Name Of The Provider | CHRISTOPHER |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 15725 POMERADO RD |
| Street Address 2 Of The Provider | SUITE 107 |
| City Of The Provider | POWAY |
| Zip Code Of The Provider | 920642068 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 3967 |
| Number Of Medicare Beneficiaries | 322 |
| Total Submitted Charge Amount | 729149.79 |
| Total Medicare Allowed Amount | 255071.97 |
| Total Medicare Payment Amount | 193764.15 |
| Total Medicare Standardized Payment Amount | 173608.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1539 |
| Number Of Medicare Beneficiaries With Drug Services | 143 |
| Total Drug Submitted ChargeAmount | 33650 |
| Total Drug Medicare AllowedAmount | 1263.06 |
| Total Drug Medicare PaymentAmount | 966.29 |
| Total Drug Medicare Standardized Payment Amount | 966.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 2428 |
| Number Of Medicare Beneficiaries With Medical Services | 322 |
| Total Medical Submitted Charge Amount | 695499.79 |
| Total Medical Medicare Allowed Amount | 253808.91 |
| Total Medical Medicare Payment Amount | 192797.86 |
| Total Medical Medicare Standardized Payment Amount | 172642.42 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 129 |
| Number Of Beneficiaries Age 75 to 84 | 86 |
| Number Of Beneficiaries Age Greater 84 | 38 |
| Number Of Female Beneficiaries | 194 |
| Number Of Male Beneficiaries | 128 |
| Number Of Non Hispanic White Beneficiaries | 284 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 274 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5113 |