| National Provider Identifier [NPI]: | 1366642738 |
| Last Name Of The Provider | BALMFORTH |
| First Name Of The Provider | RANDY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | GARDEN CITY HOSPITAL |
| Street Address 2 Of The Provider | 6245 INKSTER ROAD |
| City Of The Provider | GARDEN CITY |
| Zip Code Of The Provider | 481354001 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 173 |
| Number Of Services | 5938 |
| Number Of Medicare Beneficiaries | 2334 |
| Total Submitted Charge Amount | 354330 |
| Total Medicare Allowed Amount | 152499.77 |
| Total Medicare Payment Amount | 117313.2 |
| Total Medicare Standardized Payment Amount | 120354.63 |
| 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 | 173 |
| Number Of Medical Services | 5938 |
| Number Of Medicare Beneficiaries With Medical Services | 2334 |
| Total Medical Submitted Charge Amount | 354330 |
| Total Medical Medicare Allowed Amount | 152499.77 |
| Total Medical Medicare Payment Amount | 117313.2 |
| Total Medical Medicare Standardized Payment Amount | 120354.63 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 499 |
| Number Of Beneficiaries Age 65 to 74 | 869 |
| Number Of Beneficiaries Age 75 to 84 | 631 |
| Number Of Beneficiaries Age Greater 84 | 335 |
| Number Of Female Beneficiaries | 1535 |
| Number Of Male Beneficiaries | 799 |
| Number Of Non Hispanic White Beneficiaries | 2232 |
| Number Of Black or African American Beneficiaries | 55 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1634 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 700 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4596 |