| National Provider Identifier [NPI]: | 1629245766 |
| Last Name Of The Provider | WILLANDER |
| First Name Of The Provider | PRISCILLA |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 WILLMAR AVE SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | WILLMAR |
| Zip Code Of The Provider | 562013556 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 197 |
| Number Of Services | 2396 |
| Number Of Medicare Beneficiaries | 224 |
| Total Submitted Charge Amount | 278329.09 |
| Total Medicare Allowed Amount | 74560.15 |
| Total Medicare Payment Amount | 59810.6 |
| Total Medicare Standardized Payment Amount | 69333.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 204 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 3221.24 |
| Total Drug Medicare AllowedAmount | 1361.77 |
| Total Drug Medicare PaymentAmount | 1217.64 |
| Total Drug Medicare Standardized Payment Amount | 1217.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 183 |
| Number Of Medical Services | 2192 |
| Number Of Medicare Beneficiaries With Medical Services | 224 |
| Total Medical Submitted Charge Amount | 275107.85 |
| Total Medical Medicare Allowed Amount | 73198.38 |
| Total Medical Medicare Payment Amount | 58592.96 |
| Total Medical Medicare Standardized Payment Amount | 68116.23 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 58 |
| Number Of Beneficiaries Age 75 to 84 | 57 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 150 |
| Number Of Male Beneficiaries | 74 |
| Number Of Non Hispanic White Beneficiaries | 201 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 146 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 78 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2799 |