| National Provider Identifier [NPI]: | 1841386133 |
| Last Name Of The Provider | CHRISTOPHERSON |
| First Name Of The Provider | SUE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MSN FNP APNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | N6520 GUY ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BLACK RIVER FALLS |
| Zip Code Of The Provider | 54615 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 7261 |
| Number Of Medicare Beneficiaries | 53 |
| Total Submitted Charge Amount | 70032 |
| Total Medicare Allowed Amount | 29077.27 |
| Total Medicare Payment Amount | 23485.3 |
| Total Medicare Standardized Payment Amount | 23605.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 6615 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 37125 |
| Total Drug Medicare AllowedAmount | 24701.17 |
| Total Drug Medicare PaymentAmount | 19402.77 |
| Total Drug Medicare Standardized Payment Amount | 19402.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 646 |
| Number Of Medicare Beneficiaries With Medical Services | 51 |
| Total Medical Submitted Charge Amount | 32907 |
| Total Medical Medicare Allowed Amount | 4376.1 |
| Total Medical Medicare Payment Amount | 4082.53 |
| Total Medical Medicare Standardized Payment Amount | 4203.06 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 26 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 36 |
| Number Of Male Beneficiaries | 17 |
| 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 | 40 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 72 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 1.7792 |