| National Provider Identifier [NPI]: | 1780853085 |
| Last Name Of The Provider | WYMER |
| First Name Of The Provider | RACHAEL |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1450 E VALLEY RD |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | BASALT |
| Zip Code Of The Provider | 816218304 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 162 |
| Number Of Medicare Beneficiaries | 73 |
| Total Submitted Charge Amount | 267476 |
| Total Medicare Allowed Amount | 15243.18 |
| Total Medicare Payment Amount | 11565.66 |
| Total Medicare Standardized Payment Amount | 12557.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 52 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 13272 |
| Total Drug Medicare AllowedAmount | 5154.65 |
| Total Drug Medicare PaymentAmount | 3962.05 |
| Total Drug Medicare Standardized Payment Amount | 3962.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 110 |
| Number Of Medicare Beneficiaries With Medical Services | 73 |
| Total Medical Submitted Charge Amount | 254204 |
| Total Medical Medicare Allowed Amount | 10088.53 |
| Total Medical Medicare Payment Amount | 7603.61 |
| Total Medical Medicare Standardized Payment Amount | 8595.21 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 47 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 50 |
| Number Of Male Beneficiaries | 23 |
| 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 | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 38 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 25 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8776 |