| National Provider Identifier [NPI]: | 1245524776 |
| Last Name Of The Provider | ABRAMOVA |
| First Name Of The Provider | KAMILLA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 160 KINGSLEY LN |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | NORFOLK |
| Zip Code Of The Provider | 235054600 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 738 |
| Number Of Medicare Beneficiaries | 25 |
| Total Submitted Charge Amount | 24233 |
| Total Medicare Allowed Amount | 12882.46 |
| Total Medicare Payment Amount | 9604.3 |
| Total Medicare Standardized Payment Amount | 10059.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 686 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 16176 |
| Total Drug Medicare AllowedAmount | 10173.26 |
| Total Drug Medicare PaymentAmount | 7510.45 |
| Total Drug Medicare Standardized Payment Amount | 7510.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 52 |
| Number Of Medicare Beneficiaries With Medical Services | 25 |
| Total Medical Submitted Charge Amount | 8057 |
| Total Medical Medicare Allowed Amount | 2709.2 |
| Total Medical Medicare Payment Amount | 2093.85 |
| Total Medical Medicare Standardized Payment Amount | 2548.84 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 13 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 0 |
| Percent Of With Alzheimers Disease or Dementia | 0 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | 0 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7878 |