| National Provider Identifier [NPI]: | 1689015307 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | ABBY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1355 PACIFIC AVE |
| Street Address 2 Of The Provider | UNIT 304 |
| City Of The Provider | SAN FRANCISCO |
| Zip Code Of The Provider | 941092793 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 248 |
| Number Of Medicare Beneficiaries | 71 |
| Total Submitted Charge Amount | 5707.81 |
| Total Medicare Allowed Amount | 5208.95 |
| Total Medicare Payment Amount | 3337.05 |
| Total Medicare Standardized Payment Amount | 3704.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 169 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 741.81 |
| Total Drug Medicare AllowedAmount | 637.38 |
| Total Drug Medicare PaymentAmount | 617.61 |
| Total Drug Medicare Standardized Payment Amount | 617.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 79 |
| Number Of Medicare Beneficiaries With Medical Services | 71 |
| Total Medical Submitted Charge Amount | 4966 |
| Total Medical Medicare Allowed Amount | 4571.57 |
| Total Medical Medicare Payment Amount | 2719.44 |
| Total Medical Medicare Standardized Payment Amount | 3086.52 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 40 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 39 |
| Number Of Male Beneficiaries | 32 |
| 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 | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 20 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7632 |