National Provider Identifier [NPI]: |
1417213729 |
Last Name Of The Provider |
BAKER |
First Name Of The Provider |
LAURA |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
N.P. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5750 FALLS DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WAYNE |
Zip Code Of The Provider |
468047147 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
1749 |
Number Of Medicare Beneficiaries |
386 |
Total Submitted Charge Amount |
119631 |
Total Medicare Allowed Amount |
56469.79 |
Total Medicare Payment Amount |
42122.17 |
Total Medicare Standardized Payment Amount |
51773.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
347 |
Number Of Medicare Beneficiaries With Drug Services |
37 |
Total Drug Submitted ChargeAmount |
1463 |
Total Drug Medicare AllowedAmount |
947.26 |
Total Drug Medicare PaymentAmount |
725.4 |
Total Drug Medicare Standardized Payment Amount |
725.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
1402 |
Number Of Medicare Beneficiaries With Medical Services |
386 |
Total Medical Submitted Charge Amount |
118168 |
Total Medical Medicare Allowed Amount |
55522.53 |
Total Medical Medicare Payment Amount |
41396.77 |
Total Medical Medicare Standardized Payment Amount |
51048.53 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
142 |
Number Of Beneficiaries Age 75 to 84 |
137 |
Number Of Beneficiaries Age Greater 84 |
73 |
Number Of Female Beneficiaries |
249 |
Number Of Male Beneficiaries |
137 |
Number Of Non Hispanic White Beneficiaries |
371 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
344 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
42 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0639 |