| National Provider Identifier [NPI]: | 1063558682 |
| Last Name Of The Provider | BALMANOUKIAN |
| First Name Of The Provider | ANI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 N WOLFE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212870005 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 13411 |
| Number Of Medicare Beneficiaries | 251 |
| Total Submitted Charge Amount | 564390 |
| Total Medicare Allowed Amount | 201456.01 |
| Total Medicare Payment Amount | 156540.35 |
| Total Medicare Standardized Payment Amount | 151848.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 29 |
| Number Of Drug Services | 11927 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 219652 |
| Total Drug Medicare AllowedAmount | 72108.23 |
| Total Drug Medicare PaymentAmount | 56516.36 |
| Total Drug Medicare Standardized Payment Amount | 56516.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 1484 |
| Number Of Medicare Beneficiaries With Medical Services | 251 |
| Total Medical Submitted Charge Amount | 344738 |
| Total Medical Medicare Allowed Amount | 129347.78 |
| Total Medical Medicare Payment Amount | 100023.99 |
| Total Medical Medicare Standardized Payment Amount | 95332.08 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 125 |
| Number Of Beneficiaries Age 75 to 84 | 76 |
| Number Of Beneficiaries Age Greater 84 | 38 |
| Number Of Female Beneficiaries | 113 |
| Number Of Male Beneficiaries | 138 |
| Number Of Non Hispanic White Beneficiaries | 202 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 209 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 51 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.4007 |