| National Provider Identifier [NPI]: | 1235102658 |
| Last Name Of The Provider | HULT |
| 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 | 2635 UNIVERSITY AVE |
| Street Address 2 Of The Provider | SUITE 160 MAIL STOP 13901B |
| City Of The Provider | SAINT PAUL |
| Zip Code Of The Provider | 551141271 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 760 |
| Number Of Medicare Beneficiaries | 77 |
| Total Submitted Charge Amount | 52828 |
| Total Medicare Allowed Amount | 19041.61 |
| Total Medicare Payment Amount | 14352.79 |
| Total Medicare Standardized Payment Amount | 15064.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 344 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 1218 |
| Total Drug Medicare AllowedAmount | 689.34 |
| Total Drug Medicare PaymentAmount | 611.68 |
| Total Drug Medicare Standardized Payment Amount | 611.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 416 |
| Number Of Medicare Beneficiaries With Medical Services | 77 |
| Total Medical Submitted Charge Amount | 51610 |
| Total Medical Medicare Allowed Amount | 18352.27 |
| Total Medical Medicare Payment Amount | 13741.11 |
| Total Medical Medicare Standardized Payment Amount | 14453.07 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | 58 |
| 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 | 42 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 26 |
| Percent Of With Hypertension | 40 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.8575 |