| National Provider Identifier [NPI]: | 1942247150 |
| Last Name Of The Provider | WYATT |
| First Name Of The Provider | SAMANTHA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 620 WALNUT ST NE |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | DECATUR |
| Zip Code Of The Provider | 356012456 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 7258 |
| Number Of Medicare Beneficiaries | 1046 |
| Total Submitted Charge Amount | 333041.49 |
| Total Medicare Allowed Amount | 308554.7 |
| Total Medicare Payment Amount | 224826.23 |
| Total Medicare Standardized Payment Amount | 243057.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 32 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 7191.77 |
| Total Drug Medicare AllowedAmount | 7072.87 |
| Total Drug Medicare PaymentAmount | 5497.13 |
| Total Drug Medicare Standardized Payment Amount | 5497.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 7226 |
| Number Of Medicare Beneficiaries With Medical Services | 1046 |
| Total Medical Submitted Charge Amount | 325849.72 |
| Total Medical Medicare Allowed Amount | 301481.83 |
| Total Medical Medicare Payment Amount | 219329.1 |
| Total Medical Medicare Standardized Payment Amount | 237560.69 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 542 |
| Number Of Beneficiaries Age 75 to 84 | 358 |
| Number Of Beneficiaries Age Greater 84 | 93 |
| Number Of Female Beneficiaries | 608 |
| Number Of Male Beneficiaries | 438 |
| Number Of Non Hispanic White Beneficiaries | 1027 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 982 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9095 |