| National Provider Identifier [NPI]: | 1184693327 |
| Last Name Of The Provider | BALEY |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 745 FLETCHER DR |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | ELGIN |
| Zip Code Of The Provider | 601234747 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 20210 |
| Number Of Medicare Beneficiaries | 884 |
| Total Submitted Charge Amount | 1975508 |
| Total Medicare Allowed Amount | 571224.09 |
| Total Medicare Payment Amount | 458376.47 |
| Total Medicare Standardized Payment Amount | 446092.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 4183 |
| Number Of Medicare Beneficiaries With Drug Services | 369 |
| Total Drug Submitted ChargeAmount | 116266.8 |
| Total Drug Medicare AllowedAmount | 90363.5 |
| Total Drug Medicare PaymentAmount | 76495.58 |
| Total Drug Medicare Standardized Payment Amount | 76495.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 16027 |
| Number Of Medicare Beneficiaries With Medical Services | 884 |
| Total Medical Submitted Charge Amount | 1859241.2 |
| Total Medical Medicare Allowed Amount | 480860.59 |
| Total Medical Medicare Payment Amount | 381880.89 |
| Total Medical Medicare Standardized Payment Amount | 369597.06 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 347 |
| Number Of Beneficiaries Age 75 to 84 | 350 |
| Number Of Beneficiaries Age Greater 84 | 171 |
| Number Of Female Beneficiaries | 458 |
| Number Of Male Beneficiaries | 426 |
| Number Of Non Hispanic White Beneficiaries | 853 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 850 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0515 |