| National Provider Identifier [NPI]: | 1912089624 |
| Last Name Of The Provider | BAKER |
| First Name Of The Provider | KIM |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5300 E ERICKSON DR |
| Street Address 2 Of The Provider | STE 116 |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 857122828 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 653 |
| Number Of Medicare Beneficiaries | 169 |
| Total Submitted Charge Amount | 58346.7 |
| Total Medicare Allowed Amount | 45480.98 |
| Total Medicare Payment Amount | 30870.59 |
| Total Medicare Standardized Payment Amount | 31217.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 69 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 1703.7 |
| Total Drug Medicare AllowedAmount | 1307.77 |
| Total Drug Medicare PaymentAmount | 1257.39 |
| Total Drug Medicare Standardized Payment Amount | 1257.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 584 |
| Number Of Medicare Beneficiaries With Medical Services | 169 |
| Total Medical Submitted Charge Amount | 56643 |
| Total Medical Medicare Allowed Amount | 44173.21 |
| Total Medical Medicare Payment Amount | 29613.2 |
| Total Medical Medicare Standardized Payment Amount | 29959.94 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 84 |
| Number Of Beneficiaries Age 75 to 84 | 46 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 111 |
| Number Of Male Beneficiaries | 58 |
| Number Of Non Hispanic White Beneficiaries | 128 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 138 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0606 |