| National Provider Identifier [NPI]: | 1114934759 |
| Last Name Of The Provider | BALLINGER |
| First Name Of The Provider | KEITH |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | PA C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 168 COURTHOUSE SQUARE |
| Street Address 2 Of The Provider | |
| City Of The Provider | TOLEDO |
| Zip Code Of The Provider | 62468 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 2490 |
| Number Of Medicare Beneficiaries | 283 |
| Total Submitted Charge Amount | 135243.44 |
| Total Medicare Allowed Amount | 79614.33 |
| Total Medicare Payment Amount | 53719.6 |
| Total Medicare Standardized Payment Amount | 66165.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 349 |
| Number Of Medicare Beneficiaries With Drug Services | 93 |
| Total Drug Submitted ChargeAmount | 13698.44 |
| Total Drug Medicare AllowedAmount | 5043.06 |
| Total Drug Medicare PaymentAmount | 4333.89 |
| Total Drug Medicare Standardized Payment Amount | 4333.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 2141 |
| Number Of Medicare Beneficiaries With Medical Services | 283 |
| Total Medical Submitted Charge Amount | 121545 |
| Total Medical Medicare Allowed Amount | 74571.27 |
| Total Medical Medicare Payment Amount | 49385.71 |
| Total Medical Medicare Standardized Payment Amount | 61831.85 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 110 |
| Number Of Beneficiaries Age 75 to 84 | 80 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 170 |
| Number Of Male Beneficiaries | 113 |
| 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 | 211 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 72 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0364 |