| National Provider Identifier [NPI]: | 1275501363 |
| Last Name Of The Provider | KERALAVARMA |
| First Name Of The Provider | BALAGOPAL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1630 45TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MUNSTER |
| Zip Code Of The Provider | 463213963 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 124 |
| Number Of Services | 98247 |
| Number Of Medicare Beneficiaries | 646 |
| Total Submitted Charge Amount | 5464491.05 |
| Total Medicare Allowed Amount | 2265820.09 |
| Total Medicare Payment Amount | 1767008.67 |
| Total Medicare Standardized Payment Amount | 1778453.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 57 |
| Number Of Drug Services | 84315 |
| Number Of Medicare Beneficiaries With Drug Services | 132 |
| Total Drug Submitted ChargeAmount | 3985506.05 |
| Total Drug Medicare AllowedAmount | 1499534.85 |
| Total Drug Medicare PaymentAmount | 1168853.02 |
| Total Drug Medicare Standardized Payment Amount | 1168853.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 13932 |
| Number Of Medicare Beneficiaries With Medical Services | 646 |
| Total Medical Submitted Charge Amount | 1478985 |
| Total Medical Medicare Allowed Amount | 766285.24 |
| Total Medical Medicare Payment Amount | 598155.65 |
| Total Medical Medicare Standardized Payment Amount | 609600.41 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 102 |
| Number Of Beneficiaries Age 65 to 74 | 253 |
| Number Of Beneficiaries Age 75 to 84 | 204 |
| Number Of Beneficiaries Age Greater 84 | 87 |
| Number Of Female Beneficiaries | 359 |
| Number Of Male Beneficiaries | 287 |
| Number Of Non Hispanic White Beneficiaries | 427 |
| Number Of Black or African American Beneficiaries | 163 |
| 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 | 499 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 147 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 37 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.3645 |