| National Provider Identifier [NPI]: | 1154378354 |
| Last Name Of The Provider | CHRISTOPHERSON |
| First Name Of The Provider | LUCY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3050 MONTVALE DR STE A |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 627046924 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 110 |
| Number Of Services | 3169 |
| Number Of Medicare Beneficiaries | 2360 |
| Total Submitted Charge Amount | 1014469.37 |
| Total Medicare Allowed Amount | 297283.94 |
| Total Medicare Payment Amount | 227194.74 |
| Total Medicare Standardized Payment Amount | 245796.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 243 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 2391.18 |
| Total Drug Medicare AllowedAmount | 484.91 |
| Total Drug Medicare PaymentAmount | 365.27 |
| Total Drug Medicare Standardized Payment Amount | 365.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 108 |
| Number Of Medical Services | 2926 |
| Number Of Medicare Beneficiaries With Medical Services | 2360 |
| Total Medical Submitted Charge Amount | 1012078.19 |
| Total Medical Medicare Allowed Amount | 296799.03 |
| Total Medical Medicare Payment Amount | 226829.47 |
| Total Medical Medicare Standardized Payment Amount | 245431.38 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 482 |
| Number Of Beneficiaries Age 65 to 74 | 895 |
| Number Of Beneficiaries Age 75 to 84 | 683 |
| Number Of Beneficiaries Age Greater 84 | 300 |
| Number Of Female Beneficiaries | 1360 |
| Number Of Male Beneficiaries | 1000 |
| Number Of Non Hispanic White Beneficiaries | 2238 |
| Number Of Black or African American Beneficiaries | 76 |
| 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 | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1775 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 585 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.2401 |