| National Provider Identifier [NPI]: | 1407061815 |
| Last Name Of The Provider | CHRISTENSEN |
| First Name Of The Provider | KRISTIN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3701 MARKET ST |
| Street Address 2 Of The Provider | 6TH FLOOR, SUITE 640 |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191045502 |
| 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 | 24 |
| Number Of Services | 336 |
| Number Of Medicare Beneficiaries | 189 |
| Total Submitted Charge Amount | 49462 |
| Total Medicare Allowed Amount | 28840.41 |
| Total Medicare Payment Amount | 19646.97 |
| Total Medicare Standardized Payment Amount | 18893.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 19 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 850 |
| Total Drug Medicare AllowedAmount | 306.44 |
| Total Drug Medicare PaymentAmount | 300.34 |
| Total Drug Medicare Standardized Payment Amount | 300.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 317 |
| Number Of Medicare Beneficiaries With Medical Services | 187 |
| Total Medical Submitted Charge Amount | 48612 |
| Total Medical Medicare Allowed Amount | 28533.97 |
| Total Medical Medicare Payment Amount | 19346.63 |
| Total Medical Medicare Standardized Payment Amount | 18593.04 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 67 |
| Number Of Beneficiaries Age 65 to 74 | 74 |
| Number Of Beneficiaries Age 75 to 84 | 33 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 133 |
| Number Of Male Beneficiaries | 56 |
| Number Of Non Hispanic White Beneficiaries | 61 |
| Number Of Black or African American Beneficiaries | 113 |
| 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 | 109 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 80 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.617 |