National Provider Identifier [NPI]: |
1992718118 |
Last Name Of The Provider |
ROLANDER |
First Name Of The Provider |
BRENDA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
CNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8988 LORTON STATION BLVD |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
LORTON |
Zip Code Of The Provider |
220794756 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
56 |
Number Of Services |
1240 |
Number Of Medicare Beneficiaries |
200 |
Total Submitted Charge Amount |
86275 |
Total Medicare Allowed Amount |
36447.03 |
Total Medicare Payment Amount |
25685.26 |
Total Medicare Standardized Payment Amount |
26700.46 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
30 |
Number Of Medicare Beneficiaries With Drug Services |
24 |
Total Drug Submitted ChargeAmount |
1037 |
Total Drug Medicare AllowedAmount |
679.54 |
Total Drug Medicare PaymentAmount |
661.21 |
Total Drug Medicare Standardized Payment Amount |
661.21 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
53 |
Number Of Medical Services |
1210 |
Number Of Medicare Beneficiaries With Medical Services |
200 |
Total Medical Submitted Charge Amount |
85238 |
Total Medical Medicare Allowed Amount |
35767.49 |
Total Medical Medicare Payment Amount |
25024.05 |
Total Medical Medicare Standardized Payment Amount |
26039.25 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
101 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
122 |
Number Of Male Beneficiaries |
78 |
Number Of Non Hispanic White Beneficiaries |
148 |
Number Of Black or African American Beneficiaries |
28 |
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 |
176 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1009 |