| National Provider Identifier [NPI]: | 1356630636 |
| Last Name Of The Provider | TAYLOR |
| First Name Of The Provider | ABIGAIL |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1200 6TH AVE N |
| Street Address 2 Of The Provider | CENTRACARE CLINIC RIVER CAMPUS INTERNAL MEDICINE |
| City Of The Provider | SAINT CLOUD |
| Zip Code Of The Provider | 563032735 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 284 |
| Number Of Medicare Beneficiaries | 51 |
| Total Submitted Charge Amount | 17948.5 |
| Total Medicare Allowed Amount | 7720.91 |
| Total Medicare Payment Amount | 6409.47 |
| Total Medicare Standardized Payment Amount | 6516.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 164 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 958.5 |
| Total Drug Medicare AllowedAmount | 628.03 |
| Total Drug Medicare PaymentAmount | 600.69 |
| Total Drug Medicare Standardized Payment Amount | 600.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 120 |
| Number Of Medicare Beneficiaries With Medical Services | 51 |
| Total Medical Submitted Charge Amount | 16990 |
| Total Medical Medicare Allowed Amount | 7092.88 |
| Total Medical Medicare Payment Amount | 5808.78 |
| Total Medical Medicare Standardized Payment Amount | 5915.66 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | 17 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 35 |
| Number Of Male Beneficiaries | 16 |
| 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 | 34 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.7454 |