| National Provider Identifier [NPI]: | 1144475401 |
| Last Name Of The Provider | BALLARD |
| First Name Of The Provider | GENEVA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 GUTHRIE SQ |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAYRE |
| Zip Code Of The Provider | 188401625 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 124 |
| Number Of Services | 6090 |
| Number Of Medicare Beneficiaries | 2719 |
| Total Submitted Charge Amount | 571700 |
| Total Medicare Allowed Amount | 144337.29 |
| Total Medicare Payment Amount | 117630.14 |
| Total Medicare Standardized Payment Amount | 123546.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1060 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 1041 |
| Total Drug Medicare AllowedAmount | 334.44 |
| Total Drug Medicare PaymentAmount | 241.04 |
| Total Drug Medicare Standardized Payment Amount | 241.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 122 |
| Number Of Medical Services | 5030 |
| Number Of Medicare Beneficiaries With Medical Services | 2719 |
| Total Medical Submitted Charge Amount | 570659 |
| Total Medical Medicare Allowed Amount | 144002.85 |
| Total Medical Medicare Payment Amount | 117389.1 |
| Total Medical Medicare Standardized Payment Amount | 123305.92 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 488 |
| Number Of Beneficiaries Age 65 to 74 | 1145 |
| Number Of Beneficiaries Age 75 to 84 | 784 |
| Number Of Beneficiaries Age Greater 84 | 302 |
| Number Of Female Beneficiaries | 2064 |
| Number Of Male Beneficiaries | 655 |
| Number Of Non Hispanic White Beneficiaries | 2644 |
| Number Of Black or African American Beneficiaries | 26 |
| 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 | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2065 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 654 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2123 |