Medicare Facts for Haley K. Baltz, MSPT


National Provider Identifier [NPI]: 1003053331
Last Name Of The Provider BALTZ
First Name Of The Provider HALEY
Middle Initial Of The Provider K
Credentials Of The Provider MS PT
Gender Of The Provider F
Entity Type Of The Provider I
Street Address 1 Of The Provider 50 W 3RD ST
Street Address 2 Of The Provider
City Of The Provider SHERIDAN
Zip Code Of The Provider 828013606
State Code Of The Provider WY
Country Code Of The Provider US
Provider Type Of The Provider Physical Therapist
Medicare Participation Indicator Y
Number Of HCPCS 6
Number Of Services 364
Number Of Medicare Beneficiaries 12
Total Submitted Charge Amount 24316
Total Medicare Allowed Amount 9726.83
Total Medicare Payment Amount 7429.32
Total Medicare Standardized Payment Amount 3879.87
Drug Suppress Indicator
Number Of HCPCS Associated With Drug Services 0
Number Of Drug Services 0
Number Of Medicare Beneficiaries With Drug Services 0
Total Drug Submitted ChargeAmount 0
Total Drug Medicare AllowedAmount 0
Total Drug Medicare PaymentAmount 0
Total Drug Medicare Standardized Payment Amount 0
Medical SuppressIndicator
Number Of HCPCS Associated With MedicalServices 6
Number Of Medical Services 364
Number Of Medicare Beneficiaries With Medical Services 12
Total Medical Submitted Charge Amount 24316
Total Medical Medicare Allowed Amount 9726.83
Total Medical Medicare Payment Amount 7429.32
Total Medical Medicare Standardized Payment Amount 3879.87
Average Age Of Beneficiaries 69
Number Of Beneficiaries Age Less65
Number Of Beneficiaries Age 65 to 74
Number Of Beneficiaries Age 75 to 84
Number Of Beneficiaries Age Greater 84
Number Of Female Beneficiaries
Number Of Male Beneficiaries
Number Of Non Hispanic White Beneficiaries 12
Number Of Black or African American Beneficiaries 0
Number Of AsianPacific Islander Beneficiaries 0
Number Of Hispanic Beneficiaries 0
Number Of American Indian Alaska Native Beneficiaries 0
Number Of Beneficiaries With Race Not Else where Classified 0
Number Of Beneficiaries With Medicare Only Entitlement
Number Of Beneficiaries With Medicare Medicaid Entitlement
Percent Of With Atrial Fibrillation
Percent Of With Alzheimers Disease or Dementia 0
Percent Of With Asthma
Percent Of With Cancer
Percent Of With Heart Failure 0
Percent Of With Chronic Kidney Disease
Percent Of With Chronic Obstructive Pulmonary Disease 0
Percent Of With Depression
Percent Of With Diabetes
Percent Of With Hyperlipidemia
Percent Of With Hypertension
Percent Of With Ischemic Heart Disease
Percent Of With Osteoporosis
Percent Of With Rheumatoid Arthritis Osteoarthritis
Percent Of With Schizophrenia Other PsychoticDisorders 0
Percent Of With Stroke 0
Average HCC Risk Score Of Beneficiaries 0.4901

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