| National Provider Identifier [NPI]: | 1295732576 |
| Last Name Of The Provider | HARRELL |
| First Name Of The Provider | CHRISTINE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 120 N LEE ST |
| Street Address 2 Of The Provider | STE G |
| City Of The Provider | FORSYTH |
| Zip Code Of The Provider | 310292122 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 1981 |
| Number Of Medicare Beneficiaries | 224 |
| Total Submitted Charge Amount | 153306.32 |
| Total Medicare Allowed Amount | 57212.11 |
| Total Medicare Payment Amount | 36673.61 |
| Total Medicare Standardized Payment Amount | 49220.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 940 |
| Number Of Medicare Beneficiaries With Drug Services | 101 |
| Total Drug Submitted ChargeAmount | 16046 |
| Total Drug Medicare AllowedAmount | 1613.09 |
| Total Drug Medicare PaymentAmount | 1294 |
| Total Drug Medicare Standardized Payment Amount | 1294 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 1041 |
| Number Of Medicare Beneficiaries With Medical Services | 224 |
| Total Medical Submitted Charge Amount | 137260.32 |
| Total Medical Medicare Allowed Amount | 55599.02 |
| Total Medical Medicare Payment Amount | 35379.61 |
| Total Medical Medicare Standardized Payment Amount | 47926.67 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 88 |
| Number Of Beneficiaries Age 65 to 74 | 89 |
| Number Of Beneficiaries Age 75 to 84 | 33 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 149 |
| Number Of Male Beneficiaries | 75 |
| Number Of Non Hispanic White Beneficiaries | 135 |
| 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 | 130 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 94 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9874 |