| National Provider Identifier [NPI]: | 1063465219 |
| Last Name Of The Provider | BAKER |
| First Name Of The Provider | LORI |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 501 WASHINGTON ST |
| Street Address 2 Of The Provider | STE 510 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921032231 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 158 |
| Number Of Services | 10753 |
| Number Of Medicare Beneficiaries | 2599 |
| Total Submitted Charge Amount | 1119284.57 |
| Total Medicare Allowed Amount | 258152.31 |
| Total Medicare Payment Amount | 197073.39 |
| Total Medicare Standardized Payment Amount | 188374.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 6600 |
| Number Of Medicare Beneficiaries With Drug Services | 75 |
| Total Drug Submitted ChargeAmount | 14900 |
| Total Drug Medicare AllowedAmount | 1355.07 |
| Total Drug Medicare PaymentAmount | 1062.31 |
| Total Drug Medicare Standardized Payment Amount | 1062.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 155 |
| Number Of Medical Services | 4153 |
| Number Of Medicare Beneficiaries With Medical Services | 2599 |
| Total Medical Submitted Charge Amount | 1104384.57 |
| Total Medical Medicare Allowed Amount | 256797.24 |
| Total Medical Medicare Payment Amount | 196011.08 |
| Total Medical Medicare Standardized Payment Amount | 187312.57 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 456 |
| Number Of Beneficiaries Age 65 to 74 | 1054 |
| Number Of Beneficiaries Age 75 to 84 | 708 |
| Number Of Beneficiaries Age Greater 84 | 381 |
| Number Of Female Beneficiaries | 1578 |
| Number Of Male Beneficiaries | 1021 |
| Number Of Non Hispanic White Beneficiaries | 1735 |
| Number Of Black or African American Beneficiaries | 223 |
| Number Of AsianPacific Islander Beneficiaries | 175 |
| Number Of Hispanic Beneficiaries | 393 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 61 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1565 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1034 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.682 |