| National Provider Identifier [NPI]: | 1902233844 |
| Last Name Of The Provider | GRAHAM |
| First Name Of The Provider | DANIELLE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 885 UNION BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ENGLEWOOD |
| Zip Code Of The Provider | 453222102 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 253 |
| Number Of Medicare Beneficiaries | 143 |
| Total Submitted Charge Amount | 12707 |
| Total Medicare Allowed Amount | 8751.66 |
| Total Medicare Payment Amount | 6619.61 |
| Total Medicare Standardized Payment Amount | 7999.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 67 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 1410 |
| Total Drug Medicare AllowedAmount | 942.86 |
| Total Drug Medicare PaymentAmount | 922.51 |
| Total Drug Medicare Standardized Payment Amount | 922.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 186 |
| Number Of Medicare Beneficiaries With Medical Services | 143 |
| Total Medical Submitted Charge Amount | 11297 |
| Total Medical Medicare Allowed Amount | 7808.8 |
| Total Medical Medicare Payment Amount | 5697.1 |
| Total Medical Medicare Standardized Payment Amount | 7077.17 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 79 |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 94 |
| Number Of Male Beneficiaries | 49 |
| 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 | 132 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| 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 | 8 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8858 |