| National Provider Identifier [NPI]: | 1386757029 |
| Last Name Of The Provider | BAKER |
| First Name Of The Provider | EILEEN |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 659 BOULEVARD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DOVER |
| Zip Code Of The Provider | 44622 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 566 |
| Number Of Medicare Beneficiaries | 452 |
| Total Submitted Charge Amount | 202122 |
| Total Medicare Allowed Amount | 72239.84 |
| Total Medicare Payment Amount | 55183.3 |
| Total Medicare Standardized Payment Amount | 55819.12 |
| 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 | 27 |
| Number Of Medical Services | 566 |
| Number Of Medicare Beneficiaries With Medical Services | 452 |
| Total Medical Submitted Charge Amount | 202122 |
| Total Medical Medicare Allowed Amount | 72239.84 |
| Total Medical Medicare Payment Amount | 55183.3 |
| Total Medical Medicare Standardized Payment Amount | 55819.12 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 140 |
| Number Of Beneficiaries Age 65 to 74 | 118 |
| Number Of Beneficiaries Age 75 to 84 | 112 |
| Number Of Beneficiaries Age Greater 84 | 82 |
| Number Of Female Beneficiaries | 260 |
| Number Of Male Beneficiaries | 192 |
| Number Of Non Hispanic White Beneficiaries | 406 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 309 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 143 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6055 |