| National Provider Identifier [NPI]: | 1346288263 |
| Last Name Of The Provider | ANDERSON |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 424 YELLOWSTONE AVE STE 230 |
| Street Address 2 Of The Provider | |
| City Of The Provider | CODY |
| Zip Code Of The Provider | 82414 |
| State Code Of The Provider | WY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 1562 |
| Number Of Medicare Beneficiaries | 305 |
| Total Submitted Charge Amount | 147563.15 |
| Total Medicare Allowed Amount | 99199.17 |
| Total Medicare Payment Amount | 68369.89 |
| Total Medicare Standardized Payment Amount | 68248.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 554 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 12985.1 |
| Total Drug Medicare AllowedAmount | 9045.44 |
| Total Drug Medicare PaymentAmount | 7491.79 |
| Total Drug Medicare Standardized Payment Amount | 7491.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 1008 |
| Number Of Medicare Beneficiaries With Medical Services | 305 |
| Total Medical Submitted Charge Amount | 134578.05 |
| Total Medical Medicare Allowed Amount | 90153.73 |
| Total Medical Medicare Payment Amount | 60878.1 |
| Total Medical Medicare Standardized Payment Amount | 60757.03 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 143 |
| Number Of Beneficiaries Age 75 to 84 | 105 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 146 |
| Number Of Male Beneficiaries | 159 |
| 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 | 14 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9193 |