National Provider Identifier [NPI]: |
1063573186 |
Last Name Of The Provider |
BAKER |
First Name Of The Provider |
ROSALYN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D., M.H.S. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7501 SURRANTS ROAD |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
CLINTON |
Zip Code Of The Provider |
20735 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Allergy/Immunology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
652 |
Number Of Medicare Beneficiaries |
84 |
Total Submitted Charge Amount |
45442 |
Total Medicare Allowed Amount |
24301.8 |
Total Medicare Payment Amount |
17106.14 |
Total Medicare Standardized Payment Amount |
16286.05 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
50 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
65 |
Number Of Male Beneficiaries |
19 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
65 |
Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
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Number Of American Indian Alaska Native Beneficiaries |
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Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
67 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
17 |
Percent Of With Atrial Fibrillation |
0 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
42 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
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Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
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Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
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Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1039 |