| National Provider Identifier [NPI]: | 1245232255 |
| Last Name Of The Provider | GRABEAL |
| First Name Of The Provider | TAMARA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | APRN-CNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1303 N WASHINGTON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEATHERFORD |
| Zip Code Of The Provider | 73096 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 459 |
| Number Of Medicare Beneficiaries | 148 |
| Total Submitted Charge Amount | 34626.5 |
| Total Medicare Allowed Amount | 15813.74 |
| Total Medicare Payment Amount | 10075.17 |
| Total Medicare Standardized Payment Amount | 13513.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 190 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 1781.5 |
| Total Drug Medicare AllowedAmount | 371.8 |
| Total Drug Medicare PaymentAmount | 273.57 |
| Total Drug Medicare Standardized Payment Amount | 273.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 269 |
| Number Of Medicare Beneficiaries With Medical Services | 148 |
| Total Medical Submitted Charge Amount | 32845 |
| Total Medical Medicare Allowed Amount | 15441.94 |
| Total Medical Medicare Payment Amount | 9801.6 |
| Total Medical Medicare Standardized Payment Amount | 13240.21 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 75 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 108 |
| Number Of Male Beneficiaries | 40 |
| Number Of Non Hispanic White Beneficiaries | 131 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 114 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 35 |
| 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 | 0.8311 |