| National Provider Identifier [NPI]: | 1679756183 |
| Last Name Of The Provider | ABRAHAM |
| First Name Of The Provider | MINI |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | CRNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 701 E MARSHALL ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEST CHESTER |
| Zip Code Of The Provider | 193804412 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 108 |
| Number Of Medicare Beneficiaries | 64 |
| Total Submitted Charge Amount | 16304.71 |
| Total Medicare Allowed Amount | 7957.53 |
| Total Medicare Payment Amount | 6431.69 |
| Total Medicare Standardized Payment Amount | 7119.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 939.71 |
| Total Drug Medicare AllowedAmount | 880.43 |
| Total Drug Medicare PaymentAmount | 862.82 |
| Total Drug Medicare Standardized Payment Amount | 862.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 79 |
| Number Of Medicare Beneficiaries With Medical Services | 64 |
| Total Medical Submitted Charge Amount | 15365 |
| Total Medical Medicare Allowed Amount | 7077.1 |
| Total Medical Medicare Payment Amount | 5568.87 |
| Total Medical Medicare Standardized Payment Amount | 6256.57 |
| Average Age Of Beneficiaries | 71 |
| 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 | 40 |
| Number Of Male Beneficiaries | 24 |
| Number Of Non Hispanic White Beneficiaries | 51 |
| 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 | 17 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.7317 |