| National Provider Identifier [NPI]: | 1467689166 |
| Last Name Of The Provider | BAKER |
| First Name Of The Provider | DROSTAN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1326 N STANFORD LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | LIBERTY LAKE |
| Zip Code Of The Provider | 990195034 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 141 |
| Number Of Services | 3104 |
| Number Of Medicare Beneficiaries | 171 |
| Total Submitted Charge Amount | 223864.05 |
| Total Medicare Allowed Amount | 87123.6 |
| Total Medicare Payment Amount | 64854.16 |
| Total Medicare Standardized Payment Amount | 67290.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 1179 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 6328.53 |
| Total Drug Medicare AllowedAmount | 2582.49 |
| Total Drug Medicare PaymentAmount | 2308.41 |
| Total Drug Medicare Standardized Payment Amount | 2308.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 131 |
| Number Of Medical Services | 1925 |
| Number Of Medicare Beneficiaries With Medical Services | 171 |
| Total Medical Submitted Charge Amount | 217535.52 |
| Total Medical Medicare Allowed Amount | 84541.11 |
| Total Medical Medicare Payment Amount | 62545.75 |
| Total Medical Medicare Standardized Payment Amount | 64982.34 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 77 |
| Number Of Beneficiaries Age 75 to 84 | 55 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 63 |
| Number Of Male Beneficiaries | 108 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 157 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0435 |