| National Provider Identifier [NPI]: | 1457344541 |
| Last Name Of The Provider | WYSHAM |
| First Name Of The Provider | CAROL |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 E 5TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPOKANE |
| Zip Code Of The Provider | 992021334 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Endocrinology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 112 |
| Number Of Services | 5879 |
| Number Of Medicare Beneficiaries | 381 |
| Total Submitted Charge Amount | 419261.58 |
| Total Medicare Allowed Amount | 159685.97 |
| Total Medicare Payment Amount | 121951.47 |
| Total Medicare Standardized Payment Amount | 124926.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 1648 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 89277.7 |
| Total Drug Medicare AllowedAmount | 29486.83 |
| Total Drug Medicare PaymentAmount | 23115.99 |
| Total Drug Medicare Standardized Payment Amount | 23115.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 101 |
| Number Of Medical Services | 4231 |
| Number Of Medicare Beneficiaries With Medical Services | 381 |
| Total Medical Submitted Charge Amount | 329983.88 |
| Total Medical Medicare Allowed Amount | 130199.14 |
| Total Medical Medicare Payment Amount | 98835.48 |
| Total Medical Medicare Standardized Payment Amount | 101810.98 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 187 |
| Number Of Beneficiaries Age 75 to 84 | 104 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 257 |
| Number Of Male Beneficiaries | 124 |
| Number Of Non Hispanic White Beneficiaries | 362 |
| 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 | 330 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 71 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 20 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3976 |