| National Provider Identifier [NPI]: | 1437405891 |
| Last Name Of The Provider | BALANETSKAYA |
| First Name Of The Provider | NATALYA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5100 SW MACADAM AVE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 972396102 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 473 |
| Number Of Medicare Beneficiaries | 81 |
| Total Submitted Charge Amount | 96250 |
| Total Medicare Allowed Amount | 46785.1 |
| Total Medicare Payment Amount | 33123.64 |
| Total Medicare Standardized Payment Amount | 39155.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 31 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 840 |
| Total Drug Medicare AllowedAmount | 539.41 |
| Total Drug Medicare PaymentAmount | 528.56 |
| Total Drug Medicare Standardized Payment Amount | 528.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 442 |
| Number Of Medicare Beneficiaries With Medical Services | 81 |
| Total Medical Submitted Charge Amount | 95410 |
| Total Medical Medicare Allowed Amount | 46245.69 |
| Total Medical Medicare Payment Amount | 32595.08 |
| Total Medical Medicare Standardized Payment Amount | 38626.96 |
| Average Age Of Beneficiaries | 88 |
| 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 | 63 |
| Number Of Female Beneficiaries | 65 |
| Number Of Male Beneficiaries | 16 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 63 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 52 |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 20 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3913 |