| National Provider Identifier [NPI]: | 1093794133 |
| Last Name Of The Provider | WALLER |
| First Name Of The Provider | BRENDA |
| 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 | 1935 THOMSON DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | LYNCHBURG |
| Zip Code Of The Provider | 245011008 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 4827 |
| Number Of Medicare Beneficiaries | 380 |
| Total Submitted Charge Amount | 312064.2 |
| Total Medicare Allowed Amount | 270714.34 |
| Total Medicare Payment Amount | 216887.39 |
| Total Medicare Standardized Payment Amount | 225050.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 423 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 4045 |
| Total Drug Medicare AllowedAmount | 2242.98 |
| Total Drug Medicare PaymentAmount | 1752.04 |
| Total Drug Medicare Standardized Payment Amount | 1752.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 4404 |
| Number Of Medicare Beneficiaries With Medical Services | 380 |
| Total Medical Submitted Charge Amount | 308019.2 |
| Total Medical Medicare Allowed Amount | 268471.36 |
| Total Medical Medicare Payment Amount | 215135.35 |
| Total Medical Medicare Standardized Payment Amount | 223298.77 |
| Average Age Of Beneficiaries | 56 |
| Number Of Beneficiaries Age Less65 | 282 |
| Number Of Beneficiaries Age 65 to 74 | 76 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 245 |
| Number Of Male Beneficiaries | 135 |
| Number Of Non Hispanic White Beneficiaries | 296 |
| Number Of Black or African American Beneficiaries | 73 |
| 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 | 168 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 212 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 3 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.2929 |