National Provider Identifier [NPI]: |
1225024409 |
Last Name Of The Provider |
BALAOING |
First Name Of The Provider |
WILMER |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3950 AUSTELL RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
AUSTELL |
Zip Code Of The Provider |
301061121 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
78 |
Number Of Services |
515 |
Number Of Medicare Beneficiaries |
394 |
Total Submitted Charge Amount |
571025 |
Total Medicare Allowed Amount |
62295.87 |
Total Medicare Payment Amount |
48532.02 |
Total Medicare Standardized Payment Amount |
48517.83 |
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 |
78 |
Number Of Medical Services |
515 |
Number Of Medicare Beneficiaries With Medical Services |
394 |
Total Medical Submitted Charge Amount |
571025 |
Total Medical Medicare Allowed Amount |
62295.87 |
Total Medical Medicare Payment Amount |
48532.02 |
Total Medical Medicare Standardized Payment Amount |
48517.83 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
94 |
Number Of Beneficiaries Age 65 to 74 |
163 |
Number Of Beneficiaries Age 75 to 84 |
100 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
228 |
Number Of Male Beneficiaries |
166 |
Number Of Non Hispanic White Beneficiaries |
284 |
Number Of Black or African American Beneficiaries |
88 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
303 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
91 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.2429 |