| National Provider Identifier [NPI]: | 1710981519 |
| Last Name Of The Provider | BALLER |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 225 PHYSICIANS PARK |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | POPLAR BLUFF |
| Zip Code Of The Provider | 639013956 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 3443 |
| Number Of Medicare Beneficiaries | 663 |
| Total Submitted Charge Amount | 373197.2 |
| Total Medicare Allowed Amount | 189626.94 |
| Total Medicare Payment Amount | 139099.08 |
| Total Medicare Standardized Payment Amount | 151607.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 500 |
| Number Of Medicare Beneficiaries With Drug Services | 93 |
| Total Drug Submitted ChargeAmount | 21297 |
| Total Drug Medicare AllowedAmount | 11606.47 |
| Total Drug Medicare PaymentAmount | 9082.39 |
| Total Drug Medicare Standardized Payment Amount | 9082.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 2943 |
| Number Of Medicare Beneficiaries With Medical Services | 663 |
| Total Medical Submitted Charge Amount | 351900.2 |
| Total Medical Medicare Allowed Amount | 178020.47 |
| Total Medical Medicare Payment Amount | 130016.69 |
| Total Medical Medicare Standardized Payment Amount | 142525.49 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 177 |
| Number Of Beneficiaries Age 65 to 74 | 254 |
| Number Of Beneficiaries Age 75 to 84 | 147 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 385 |
| Number Of Male Beneficiaries | 278 |
| Number Of Non Hispanic White Beneficiaries | 642 |
| 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 | 418 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 245 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6905 |