| National Provider Identifier [NPI]: | 1558531921 |
| Last Name Of The Provider | ROULIER |
| First Name Of The Provider | RACHELLE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | P.A. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 19 MYRTLE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MEDFORD |
| Zip Code Of The Provider | 975047337 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 137 |
| Number Of Services | 2915 |
| Number Of Medicare Beneficiaries | 351 |
| Total Submitted Charge Amount | 145174 |
| Total Medicare Allowed Amount | 52876.93 |
| Total Medicare Payment Amount | 41241.7 |
| Total Medicare Standardized Payment Amount | 47419.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 1502 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 1874 |
| Total Drug Medicare AllowedAmount | 526.46 |
| Total Drug Medicare PaymentAmount | 442.35 |
| Total Drug Medicare Standardized Payment Amount | 442.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 123 |
| Number Of Medical Services | 1413 |
| Number Of Medicare Beneficiaries With Medical Services | 351 |
| Total Medical Submitted Charge Amount | 143300 |
| Total Medical Medicare Allowed Amount | 52350.47 |
| Total Medical Medicare Payment Amount | 40799.35 |
| Total Medical Medicare Standardized Payment Amount | 46977.27 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 136 |
| Number Of Beneficiaries Age 75 to 84 | 97 |
| Number Of Beneficiaries Age Greater 84 | 65 |
| Number Of Female Beneficiaries | 236 |
| Number Of Male Beneficiaries | 115 |
| Number Of Non Hispanic White Beneficiaries | 334 |
| 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 | 290 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 61 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0926 |