| National Provider Identifier [NPI]: | 1306276589 |
| Last Name Of The Provider | GEDAFIE |
| First Name Of The Provider | TEWABECH |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | CRNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 546 N FREDERICK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GAITHERSBURG |
| Zip Code Of The Provider | 208772504 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 1037 |
| Number Of Medicare Beneficiaries | 515 |
| Total Submitted Charge Amount | 33819.66 |
| Total Medicare Allowed Amount | 32284.54 |
| Total Medicare Payment Amount | 28787.96 |
| Total Medicare Standardized Payment Amount | 31149.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 443 |
| Number Of Medicare Beneficiaries With Drug Services | 412 |
| Total Drug Submitted ChargeAmount | 13749.66 |
| Total Drug Medicare AllowedAmount | 13512.54 |
| Total Drug Medicare PaymentAmount | 13137.76 |
| Total Drug Medicare Standardized Payment Amount | 13137.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 594 |
| Number Of Medicare Beneficiaries With Medical Services | 512 |
| Total Medical Submitted Charge Amount | 20070 |
| Total Medical Medicare Allowed Amount | 18772 |
| Total Medical Medicare Payment Amount | 15650.2 |
| Total Medical Medicare Standardized Payment Amount | 18011.92 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 234 |
| Number Of Beneficiaries Age 75 to 84 | 209 |
| Number Of Beneficiaries Age Greater 84 | 57 |
| Number Of Female Beneficiaries | 305 |
| Number Of Male Beneficiaries | 210 |
| Number Of Non Hispanic White Beneficiaries | 403 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | 43 |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 487 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 4 |
| Percent Of With Chronic Kidney Disease | 7 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 3 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7281 |