| National Provider Identifier [NPI]: | 1548221674 |
| Last Name Of The Provider | BAEHREN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2142 N COVE BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TOLEDO |
| Zip Code Of The Provider | 436063895 |
| 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 | 41 |
| Number Of Services | 747 |
| Number Of Medicare Beneficiaries | 598 |
| Total Submitted Charge Amount | 301673 |
| Total Medicare Allowed Amount | 97951.95 |
| Total Medicare Payment Amount | 76381.68 |
| Total Medicare Standardized Payment Amount | 77420.66 |
| 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 | 41 |
| Number Of Medical Services | 747 |
| Number Of Medicare Beneficiaries With Medical Services | 598 |
| Total Medical Submitted Charge Amount | 301673 |
| Total Medical Medicare Allowed Amount | 97951.95 |
| Total Medical Medicare Payment Amount | 76381.68 |
| Total Medical Medicare Standardized Payment Amount | 77420.66 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 220 |
| Number Of Beneficiaries Age 65 to 74 | 172 |
| Number Of Beneficiaries Age 75 to 84 | 116 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 348 |
| Number Of Male Beneficiaries | 250 |
| Number Of Non Hispanic White Beneficiaries | 560 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 346 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 252 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5916 |