| National Provider Identifier [NPI]: | 1003867037 |
| Last Name Of The Provider | ECKSTROM |
| First Name Of The Provider | JENNIE |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1111 BAKER AVE |
| Street Address 2 Of The Provider | GLACIER MEDICAL ASSOCIATES |
| City Of The Provider | WHITEFISH |
| Zip Code Of The Provider | 599372901 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 1940 |
| Number Of Medicare Beneficiaries | 283 |
| Total Submitted Charge Amount | 147841.13 |
| Total Medicare Allowed Amount | 82226.22 |
| Total Medicare Payment Amount | 63855.98 |
| Total Medicare Standardized Payment Amount | 63743.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 251 |
| Number Of Medicare Beneficiaries With Drug Services | 88 |
| Total Drug Submitted ChargeAmount | 5066.81 |
| Total Drug Medicare AllowedAmount | 2676.26 |
| Total Drug Medicare PaymentAmount | 2547.84 |
| Total Drug Medicare Standardized Payment Amount | 2547.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 85 |
| Number Of Medical Services | 1689 |
| Number Of Medicare Beneficiaries With Medical Services | 283 |
| Total Medical Submitted Charge Amount | 142774.32 |
| Total Medical Medicare Allowed Amount | 79549.96 |
| Total Medical Medicare Payment Amount | 61308.14 |
| Total Medical Medicare Standardized Payment Amount | 61195.84 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 154 |
| Number Of Beneficiaries Age 75 to 84 | 66 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 198 |
| Number Of Male Beneficiaries | 85 |
| 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 | 252 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8241 |