| National Provider Identifier [NPI]: | 1821074600 |
| Last Name Of The Provider | ROLAND |
| First Name Of The Provider | DONALD |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 555 W COURT ST |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | KANKAKEE |
| Zip Code Of The Provider | 609013664 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 14217 |
| Number Of Medicare Beneficiaries | 620 |
| Total Submitted Charge Amount | 2633823.81 |
| Total Medicare Allowed Amount | 588361.39 |
| Total Medicare Payment Amount | 451126.24 |
| Total Medicare Standardized Payment Amount | 459345.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 8004.5 |
| Number Of Medicare Beneficiaries With Drug Services | 400 |
| Total Drug Submitted ChargeAmount | 401940 |
| Total Drug Medicare AllowedAmount | 15396.12 |
| Total Drug Medicare PaymentAmount | 11747.67 |
| Total Drug Medicare Standardized Payment Amount | 11747.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 76 |
| Number Of Medical Services | 6212.5 |
| Number Of Medicare Beneficiaries With Medical Services | 620 |
| Total Medical Submitted Charge Amount | 2231883.81 |
| Total Medical Medicare Allowed Amount | 572965.27 |
| Total Medical Medicare Payment Amount | 439378.57 |
| Total Medical Medicare Standardized Payment Amount | 447597.46 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 201 |
| Number Of Beneficiaries Age 65 to 74 | 222 |
| Number Of Beneficiaries Age 75 to 84 | 136 |
| Number Of Beneficiaries Age Greater 84 | 61 |
| Number Of Female Beneficiaries | 392 |
| Number Of Male Beneficiaries | 228 |
| Number Of Non Hispanic White Beneficiaries | 505 |
| Number Of Black or African American Beneficiaries | 86 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 451 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 169 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4067 |