| National Provider Identifier [NPI]: | 1780602367 |
| Last Name Of The Provider | BALMFORTH |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 801 S STEVENS ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPOKANE |
| Zip Code Of The Provider | 992042654 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 137 |
| Number Of Services | 20365 |
| Number Of Medicare Beneficiaries | 4584 |
| Total Submitted Charge Amount | 1579785.02 |
| Total Medicare Allowed Amount | 468603.41 |
| Total Medicare Payment Amount | 377011.87 |
| Total Medicare Standardized Payment Amount | 377138.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 13466 |
| Number Of Medicare Beneficiaries With Drug Services | 157 |
| Total Drug Submitted ChargeAmount | 9023.88 |
| Total Drug Medicare AllowedAmount | 3837.59 |
| Total Drug Medicare PaymentAmount | 2972.51 |
| Total Drug Medicare Standardized Payment Amount | 2972.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 135 |
| Number Of Medical Services | 6899 |
| Number Of Medicare Beneficiaries With Medical Services | 4584 |
| Total Medical Submitted Charge Amount | 1570761.14 |
| Total Medical Medicare Allowed Amount | 464765.82 |
| Total Medical Medicare Payment Amount | 374039.36 |
| Total Medical Medicare Standardized Payment Amount | 374166.29 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 689 |
| Number Of Beneficiaries Age 65 to 74 | 1890 |
| Number Of Beneficiaries Age 75 to 84 | 1361 |
| Number Of Beneficiaries Age Greater 84 | 644 |
| Number Of Female Beneficiaries | 3040 |
| Number Of Male Beneficiaries | 1544 |
| Number Of Non Hispanic White Beneficiaries | 4207 |
| Number Of Black or African American Beneficiaries | 46 |
| Number Of AsianPacific Islander Beneficiaries | 61 |
| Number Of Hispanic Beneficiaries | 134 |
| Number Of American Indian Alaska Native Beneficiaries | 89 |
| Number Of Beneficiaries With Race Not Else where Classified | 47 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3655 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 929 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4697 |