| National Provider Identifier [NPI]: | 1790943348 |
| Last Name Of The Provider | CHILDERS |
| First Name Of The Provider | KRISTIN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1900 ELECTRIC RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SALEM |
| Zip Code Of The Provider | 241537474 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 903 |
| Number Of Medicare Beneficiaries | 368 |
| Total Submitted Charge Amount | 335965 |
| Total Medicare Allowed Amount | 86947.98 |
| Total Medicare Payment Amount | 65642.81 |
| Total Medicare Standardized Payment Amount | 67623.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 903 |
| Number Of Medicare Beneficiaries With Medical Services | 368 |
| Total Medical Submitted Charge Amount | 335965 |
| Total Medical Medicare Allowed Amount | 86947.98 |
| Total Medical Medicare Payment Amount | 65642.81 |
| Total Medical Medicare Standardized Payment Amount | 67623.56 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 101 |
| Number Of Beneficiaries Age 75 to 84 | 123 |
| Number Of Beneficiaries Age Greater 84 | 97 |
| Number Of Female Beneficiaries | 202 |
| Number Of Male Beneficiaries | 166 |
| Number Of Non Hispanic White Beneficiaries | 332 |
| 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 | 281 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 87 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.0839 |