| National Provider Identifier [NPI]: | 1255403457 |
| Last Name Of The Provider | WRENN |
| First Name Of The Provider | DIANE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | ARNP, FNP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1130 MAJOR AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | RIVERTON |
| Zip Code Of The Provider | 825012342 |
| State Code Of The Provider | WY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 698 |
| Number Of Medicare Beneficiaries | 131 |
| Total Submitted Charge Amount | 50520 |
| Total Medicare Allowed Amount | 23175.68 |
| Total Medicare Payment Amount | 13835.22 |
| Total Medicare Standardized Payment Amount | 17153.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 242 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 2238 |
| Total Drug Medicare AllowedAmount | 642.98 |
| Total Drug Medicare PaymentAmount | 536.78 |
| Total Drug Medicare Standardized Payment Amount | 536.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 456 |
| Number Of Medicare Beneficiaries With Medical Services | 131 |
| Total Medical Submitted Charge Amount | 48282 |
| Total Medical Medicare Allowed Amount | 22532.7 |
| Total Medical Medicare Payment Amount | 13298.44 |
| Total Medical Medicare Standardized Payment Amount | 16616.53 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 62 |
| Number Of Beneficiaries Age 75 to 84 | 35 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 81 |
| Number Of Male Beneficiaries | 50 |
| Number Of Non Hispanic White Beneficiaries | 95 |
| 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 | 110 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 12 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 0 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7831 |