| National Provider Identifier [NPI]: | 1154365252 |
| Last Name Of The Provider | BALCUEVA |
| First Name Of The Provider | ERNIE |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 COOPER AVE |
| Street Address 2 Of The Provider | STE 10 |
| City Of The Provider | SAGINAW |
| Zip Code Of The Provider | 486025373 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 85031 |
| Number Of Medicare Beneficiaries | 437 |
| Total Submitted Charge Amount | 1873231.59 |
| Total Medicare Allowed Amount | 1134885.24 |
| Total Medicare Payment Amount | 882899.95 |
| Total Medicare Standardized Payment Amount | 890668.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 41 |
| Number Of Drug Services | 78548 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 1303359.59 |
| Total Drug Medicare AllowedAmount | 794284.27 |
| Total Drug Medicare PaymentAmount | 621967.97 |
| Total Drug Medicare Standardized Payment Amount | 621967.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 6483 |
| Number Of Medicare Beneficiaries With Medical Services | 437 |
| Total Medical Submitted Charge Amount | 569872 |
| Total Medical Medicare Allowed Amount | 340600.97 |
| Total Medical Medicare Payment Amount | 260931.98 |
| Total Medical Medicare Standardized Payment Amount | 268700.56 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 189 |
| Number Of Beneficiaries Age 75 to 84 | 129 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 276 |
| Number Of Male Beneficiaries | 161 |
| Number Of Non Hispanic White Beneficiaries | 330 |
| Number Of Black or African American Beneficiaries | 93 |
| 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 | 351 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 75 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9811 |