| National Provider Identifier [NPI]: | 1164640058 |
| Last Name Of The Provider | BALMER |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1414 W FAIR AVE |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | MARQUETTE |
| Zip Code Of The Provider | 498552675 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 5039 |
| Number Of Medicare Beneficiaries | 295 |
| Total Submitted Charge Amount | 171831.94 |
| Total Medicare Allowed Amount | 164870.39 |
| Total Medicare Payment Amount | 129383.23 |
| Total Medicare Standardized Payment Amount | 134744.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 196 |
| Number Of Medicare Beneficiaries With Drug Services | 149 |
| Total Drug Submitted ChargeAmount | 6960.11 |
| Total Drug Medicare AllowedAmount | 6341.97 |
| Total Drug Medicare PaymentAmount | 6201.8 |
| Total Drug Medicare Standardized Payment Amount | 6201.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 4843 |
| Number Of Medicare Beneficiaries With Medical Services | 295 |
| Total Medical Submitted Charge Amount | 164871.83 |
| Total Medical Medicare Allowed Amount | 158528.42 |
| Total Medical Medicare Payment Amount | 123181.43 |
| Total Medical Medicare Standardized Payment Amount | 128542.83 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 133 |
| Number Of Beneficiaries Age 75 to 84 | 83 |
| Number Of Beneficiaries Age Greater 84 | 58 |
| Number Of Female Beneficiaries | 167 |
| Number Of Male Beneficiaries | 128 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9134 |