| National Provider Identifier [NPI]: | 1609146562 |
| Last Name Of The Provider | CHRISTIANSEN |
| First Name Of The Provider | JENNIFER |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | NP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 25 NEW HAMPSHIRE AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | PORTSMOUTH |
| Zip Code Of The Provider | 038012841 |
| State Code Of The Provider | NH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 450 |
| Number Of Medicare Beneficiaries | 168 |
| Total Submitted Charge Amount | 55726 |
| Total Medicare Allowed Amount | 25668.11 |
| Total Medicare Payment Amount | 18550.28 |
| Total Medicare Standardized Payment Amount | 22169.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 11 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 259 |
| Total Drug Medicare AllowedAmount | 234.14 |
| Total Drug Medicare PaymentAmount | 229.11 |
| Total Drug Medicare Standardized Payment Amount | 229.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 439 |
| Number Of Medicare Beneficiaries With Medical Services | 168 |
| Total Medical Submitted Charge Amount | 55467 |
| Total Medical Medicare Allowed Amount | 25433.97 |
| Total Medical Medicare Payment Amount | 18321.17 |
| Total Medical Medicare Standardized Payment Amount | 21939.98 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 72 |
| Number Of Beneficiaries Age 65 to 74 | 61 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 116 |
| Number Of Male Beneficiaries | 52 |
| 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 | 115 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 20 |
| Percent Of With Hypertension | 42 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9479 |