| National Provider Identifier [NPI]: | 1730260456 |
| Last Name Of The Provider | BAKLANOV |
| First Name Of The Provider | DMITRI |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4330 WORNALL RD |
| Street Address 2 Of The Provider | SUITE 2000 |
| City Of The Provider | KANSAS CITY |
| Zip Code Of The Provider | 641115939 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 2837 |
| Number Of Medicare Beneficiaries | 1607 |
| Total Submitted Charge Amount | 659521 |
| Total Medicare Allowed Amount | 196844.61 |
| Total Medicare Payment Amount | 144927.53 |
| Total Medicare Standardized Payment Amount | 152777.3 |
| 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 | 70 |
| Number Of Medical Services | 2837 |
| Number Of Medicare Beneficiaries With Medical Services | 1607 |
| Total Medical Submitted Charge Amount | 659521 |
| Total Medical Medicare Allowed Amount | 196844.61 |
| Total Medical Medicare Payment Amount | 144927.53 |
| Total Medical Medicare Standardized Payment Amount | 152777.3 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 119 |
| Number Of Beneficiaries Age 65 to 74 | 514 |
| Number Of Beneficiaries Age 75 to 84 | 560 |
| Number Of Beneficiaries Age Greater 84 | 414 |
| Number Of Female Beneficiaries | 864 |
| Number Of Male Beneficiaries | 743 |
| Number Of Non Hispanic White Beneficiaries | 1498 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1489 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 118 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5048 |