National Provider Identifier [NPI]: |
1740293166 |
Last Name Of The Provider |
BALMER |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
435 LANCASTER DR NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SALEM |
Zip Code Of The Provider |
97301 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
524 |
Number Of Medicare Beneficiaries |
171 |
Total Submitted Charge Amount |
36448 |
Total Medicare Allowed Amount |
21772.36 |
Total Medicare Payment Amount |
16085.65 |
Total Medicare Standardized Payment Amount |
17685.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
135 |
Number Of Medicare Beneficiaries With Drug Services |
132 |
Total Drug Submitted ChargeAmount |
2711 |
Total Drug Medicare AllowedAmount |
1811.86 |
Total Drug Medicare PaymentAmount |
1770.37 |
Total Drug Medicare Standardized Payment Amount |
1770.37 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
389 |
Number Of Medicare Beneficiaries With Medical Services |
169 |
Total Medical Submitted Charge Amount |
33737 |
Total Medical Medicare Allowed Amount |
19960.5 |
Total Medical Medicare Payment Amount |
14315.28 |
Total Medical Medicare Standardized Payment Amount |
15915.61 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
42 |
Number Of Beneficiaries Age 75 to 84 |
36 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
98 |
Number Of Male Beneficiaries |
73 |
Number Of Non Hispanic White Beneficiaries |
159 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
141 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
30 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
10 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0463 |