| National Provider Identifier [NPI]: | 1619053493 |
| Last Name Of The Provider | BAXLEY |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2629 EDGEWATER DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ORLANDO |
| Zip Code Of The Provider | 328044459 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 700 |
| Number Of Medicare Beneficiaries | 212 |
| Total Submitted Charge Amount | 60262.08 |
| Total Medicare Allowed Amount | 51462.76 |
| Total Medicare Payment Amount | 36096.54 |
| Total Medicare Standardized Payment Amount | 39624.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 50 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 1998.29 |
| Total Drug Medicare AllowedAmount | 1840.88 |
| Total Drug Medicare PaymentAmount | 1797.56 |
| Total Drug Medicare Standardized Payment Amount | 1797.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 650 |
| Number Of Medicare Beneficiaries With Medical Services | 212 |
| Total Medical Submitted Charge Amount | 58263.79 |
| Total Medical Medicare Allowed Amount | 49621.88 |
| Total Medical Medicare Payment Amount | 34298.98 |
| Total Medical Medicare Standardized Payment Amount | 37827.09 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 99 |
| Number Of Beneficiaries Age 75 to 84 | 71 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 115 |
| Number Of Male Beneficiaries | 97 |
| Number Of Non Hispanic White Beneficiaries | 198 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8148 |