| National Provider Identifier [NPI]: | 1265673768 |
| Last Name Of The Provider | WIYATHUNGE |
| First Name Of The Provider | GAMINI |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | ANP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 225 N WILLOW AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | COOKEVILLE |
| Zip Code Of The Provider | 385012335 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 115 |
| Number Of Services | 1468 |
| Number Of Medicare Beneficiaries | 281 |
| Total Submitted Charge Amount | 93904.5 |
| Total Medicare Allowed Amount | 41172.02 |
| Total Medicare Payment Amount | 32849.87 |
| Total Medicare Standardized Payment Amount | 39250.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 260 |
| Number Of Medicare Beneficiaries With Drug Services | 71 |
| Total Drug Submitted ChargeAmount | 7634 |
| Total Drug Medicare AllowedAmount | 740.82 |
| Total Drug Medicare PaymentAmount | 644.32 |
| Total Drug Medicare Standardized Payment Amount | 644.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 98 |
| Number Of Medical Services | 1208 |
| Number Of Medicare Beneficiaries With Medical Services | 281 |
| Total Medical Submitted Charge Amount | 86270.5 |
| Total Medical Medicare Allowed Amount | 40431.2 |
| Total Medical Medicare Payment Amount | 32205.55 |
| Total Medical Medicare Standardized Payment Amount | 38605.69 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 137 |
| Number Of Beneficiaries Age 65 to 74 | 99 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 157 |
| Number Of Male Beneficiaries | 124 |
| Number Of Non Hispanic White Beneficiaries | 268 |
| 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 | 120 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 161 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2456 |