| National Provider Identifier [NPI]: | 1689635245 |
| Last Name Of The Provider | CHRISTENSEN |
| First Name Of The Provider | EDWIN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 TOWNCENTER BLVD |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | TUSCALOOSA |
| Zip Code Of The Provider | 354061833 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 3601 |
| Number Of Medicare Beneficiaries | 290 |
| Total Submitted Charge Amount | 219256 |
| Total Medicare Allowed Amount | 148389.7 |
| Total Medicare Payment Amount | 108839.47 |
| Total Medicare Standardized Payment Amount | 119898.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 674 |
| Number Of Medicare Beneficiaries With Drug Services | 142 |
| Total Drug Submitted ChargeAmount | 23120 |
| Total Drug Medicare AllowedAmount | 3561.7 |
| Total Drug Medicare PaymentAmount | 3349.66 |
| Total Drug Medicare Standardized Payment Amount | 3349.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 2927 |
| Number Of Medicare Beneficiaries With Medical Services | 290 |
| Total Medical Submitted Charge Amount | 196136 |
| Total Medical Medicare Allowed Amount | 144828 |
| Total Medical Medicare Payment Amount | 105489.81 |
| Total Medical Medicare Standardized Payment Amount | 116548.58 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 121 |
| Number Of Beneficiaries Age 65 to 74 | 97 |
| Number Of Beneficiaries Age 75 to 84 | 55 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 180 |
| Number Of Male Beneficiaries | 110 |
| Number Of Non Hispanic White Beneficiaries | 220 |
| 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 | 198 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.415 |