| National Provider Identifier [NPI]: | 1811995673 |
| Last Name Of The Provider | ABRAHAM |
| First Name Of The Provider | RENNY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5701 BOW POINTE DRIVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | CLARKSTON |
| Zip Code Of The Provider | 483463199 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pediatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 102 |
| Number Of Services | 3400 |
| Number Of Medicare Beneficiaries | 808 |
| Total Submitted Charge Amount | 215790 |
| Total Medicare Allowed Amount | 164552.72 |
| Total Medicare Payment Amount | 119515.49 |
| Total Medicare Standardized Payment Amount | 118715.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 25 |
| Number Of Drug Services | 1167 |
| Number Of Medicare Beneficiaries With Drug Services | 208 |
| Total Drug Submitted ChargeAmount | 7714 |
| Total Drug Medicare AllowedAmount | 2633.36 |
| Total Drug Medicare PaymentAmount | 2401.23 |
| Total Drug Medicare Standardized Payment Amount | 2401.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 2233 |
| Number Of Medicare Beneficiaries With Medical Services | 808 |
| Total Medical Submitted Charge Amount | 208076 |
| Total Medical Medicare Allowed Amount | 161919.36 |
| Total Medical Medicare Payment Amount | 117114.26 |
| Total Medical Medicare Standardized Payment Amount | 116314.03 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 193 |
| Number Of Beneficiaries Age 65 to 74 | 344 |
| Number Of Beneficiaries Age 75 to 84 | 191 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 452 |
| Number Of Male Beneficiaries | 356 |
| Number Of Non Hispanic White Beneficiaries | 747 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 670 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 138 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2371 |