| National Provider Identifier [NPI]: | 1619955507 |
| Last Name Of The Provider | ABRAHAM |
| First Name Of The Provider | OMANA |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MSN, CRNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8234 W CHESTER PIKE |
| Street Address 2 Of The Provider | |
| City Of The Provider | UPPER DARBY |
| Zip Code Of The Provider | 190822723 |
| 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 | 8 |
| Number Of Services | 1583 |
| Number Of Medicare Beneficiaries | 348 |
| Total Submitted Charge Amount | 198571.9 |
| Total Medicare Allowed Amount | 118917.32 |
| Total Medicare Payment Amount | 91475.88 |
| Total Medicare Standardized Payment Amount | 102523.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 1583 |
| Number Of Medicare Beneficiaries With Medical Services | 348 |
| Total Medical Submitted Charge Amount | 198571.9 |
| Total Medical Medicare Allowed Amount | 118917.32 |
| Total Medical Medicare Payment Amount | 91475.88 |
| Total Medical Medicare Standardized Payment Amount | 102523.62 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 111 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | 94 |
| Number Of Female Beneficiaries | 153 |
| Number Of Male Beneficiaries | 195 |
| Number Of Non Hispanic White Beneficiaries | 36 |
| Number Of Black or African American Beneficiaries | 295 |
| 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 | 38 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 310 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 71 |
| Percent Of With Chronic Kidney Disease | 56 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 71 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 28 |
| Percent Of With Stroke | 28 |
| Average HCC Risk Score Of Beneficiaries | 3.2913 |