| National Provider Identifier [NPI]: | 1013022292 |
| Last Name Of The Provider | BALLO |
| First Name Of The Provider | FRANCES |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2617 DEVELOPMENT DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GREEN BAY |
| Zip Code Of The Provider | 543114240 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 4942 |
| Number Of Medicare Beneficiaries | 619 |
| Total Submitted Charge Amount | 772449.73 |
| Total Medicare Allowed Amount | 211677.98 |
| Total Medicare Payment Amount | 152380.52 |
| Total Medicare Standardized Payment Amount | 157832.12 |
| Drug Suppress Indicator | * |
| Number Of HCPCS Associated With Drug Services | |
| Number Of Drug Services | |
| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
| Total Drug Medicare AllowedAmount | |
| Total Drug Medicare PaymentAmount | |
| Total Drug Medicare Standardized Payment Amount | |
| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
| Number Of Medical Services | |
| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
| Total Medical Medicare Payment Amount | |
| Total Medical Medicare Standardized Payment Amount | |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 296 |
| Number Of Beneficiaries Age 75 to 84 | 195 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 390 |
| Number Of Male Beneficiaries | 229 |
| Number Of Non Hispanic White Beneficiaries | 598 |
| 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 | 563 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9139 |