| National Provider Identifier [NPI]: | 1730191982 |
| Last Name Of The Provider | UBER |
| First Name Of The Provider | CHRISTINE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2031 PEACH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WISCONSIN RAPIDS |
| Zip Code Of The Provider | 544945181 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 127 |
| Number Of Services | 5266 |
| Number Of Medicare Beneficiaries | 289 |
| Total Submitted Charge Amount | 448708.5 |
| Total Medicare Allowed Amount | 110000.38 |
| Total Medicare Payment Amount | 87612.81 |
| Total Medicare Standardized Payment Amount | 91200.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 2061 |
| Number Of Medicare Beneficiaries With Drug Services | 75 |
| Total Drug Submitted ChargeAmount | 9581 |
| Total Drug Medicare AllowedAmount | 2243.55 |
| Total Drug Medicare PaymentAmount | 2063.74 |
| Total Drug Medicare Standardized Payment Amount | 2063.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 120 |
| Number Of Medical Services | 3205 |
| Number Of Medicare Beneficiaries With Medical Services | 289 |
| Total Medical Submitted Charge Amount | 439127.5 |
| Total Medical Medicare Allowed Amount | 107756.83 |
| Total Medical Medicare Payment Amount | 85549.07 |
| Total Medical Medicare Standardized Payment Amount | 89137.12 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 95 |
| Number Of Beneficiaries Age 75 to 84 | 90 |
| Number Of Beneficiaries Age Greater 84 | 57 |
| Number Of Female Beneficiaries | 231 |
| Number Of Male Beneficiaries | 58 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 217 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 72 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 31 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9734 |