| National Provider Identifier [NPI]: | 1245239623 |
| Last Name Of The Provider | ABRAHAMSON |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2424 128TH ST |
| Street Address 2 Of The Provider | NW 128TH STREET |
| City Of The Provider | URBANDALE |
| Zip Code Of The Provider | 503231816 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 92 |
| Number Of Services | 8746 |
| Number Of Medicare Beneficiaries | 1447 |
| Total Submitted Charge Amount | 1043089.11 |
| Total Medicare Allowed Amount | 453213.99 |
| Total Medicare Payment Amount | 318050.47 |
| Total Medicare Standardized Payment Amount | 345974.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 133 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 532 |
| Total Drug Medicare AllowedAmount | 254.71 |
| Total Drug Medicare PaymentAmount | 185.66 |
| Total Drug Medicare Standardized Payment Amount | 185.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 90 |
| Number Of Medical Services | 8613 |
| Number Of Medicare Beneficiaries With Medical Services | 1447 |
| Total Medical Submitted Charge Amount | 1042557.11 |
| Total Medical Medicare Allowed Amount | 452959.28 |
| Total Medical Medicare Payment Amount | 317864.81 |
| Total Medical Medicare Standardized Payment Amount | 345789.28 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 764 |
| Number Of Beneficiaries Age 75 to 84 | 466 |
| Number Of Beneficiaries Age Greater 84 | 155 |
| Number Of Female Beneficiaries | 715 |
| Number Of Male Beneficiaries | 732 |
| Number Of Non Hispanic White Beneficiaries | 1405 |
| 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 | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1403 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.791 |