National Provider Identifier [NPI]: |
1679572614 |
Last Name Of The Provider |
BAUM |
First Name Of The Provider |
YVONNE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
700 OLYMPIC PLAZA CIR |
Street Address 2 Of The Provider |
SUITE 912 |
City Of The Provider |
TYLER |
Zip Code Of The Provider |
757011951 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
709 |
Number Of Medicare Beneficiaries |
199 |
Total Submitted Charge Amount |
105927.5 |
Total Medicare Allowed Amount |
66489.93 |
Total Medicare Payment Amount |
49452.47 |
Total Medicare Standardized Payment Amount |
52740.04 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
26 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
1290 |
Total Drug Medicare AllowedAmount |
344.42 |
Total Drug Medicare PaymentAmount |
328.52 |
Total Drug Medicare Standardized Payment Amount |
328.52 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
683 |
Number Of Medicare Beneficiaries With Medical Services |
199 |
Total Medical Submitted Charge Amount |
104637.5 |
Total Medical Medicare Allowed Amount |
66145.51 |
Total Medical Medicare Payment Amount |
49123.95 |
Total Medical Medicare Standardized Payment Amount |
52411.52 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
50 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
147 |
Number Of Male Beneficiaries |
52 |
Number Of Non Hispanic White Beneficiaries |
169 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
158 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.1688 |