| National Provider Identifier [NPI]: | 1538273859 |
| Last Name Of The Provider | BAKER |
| First Name Of The Provider | SHANE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 520 S 7TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | VINCENNES |
| Zip Code Of The Provider | 475911038 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 184 |
| Number Of Services | 5683 |
| Number Of Medicare Beneficiaries | 2679 |
| Total Submitted Charge Amount | 681335 |
| Total Medicare Allowed Amount | 165304.25 |
| Total Medicare Payment Amount | 128367.69 |
| Total Medicare Standardized Payment Amount | 132927.12 |
| 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 | 184 |
| Number Of Medical Services | 5683 |
| Number Of Medicare Beneficiaries With Medical Services | 2679 |
| Total Medical Submitted Charge Amount | 681335 |
| Total Medical Medicare Allowed Amount | 165304.25 |
| Total Medical Medicare Payment Amount | 128367.69 |
| Total Medical Medicare Standardized Payment Amount | 132927.12 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 415 |
| Number Of Beneficiaries Age 65 to 74 | 1196 |
| Number Of Beneficiaries Age 75 to 84 | 787 |
| Number Of Beneficiaries Age Greater 84 | 281 |
| Number Of Female Beneficiaries | 1600 |
| Number Of Male Beneficiaries | 1079 |
| Number Of Non Hispanic White Beneficiaries | 2534 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 64 |
| Number Of American Indian Alaska Native Beneficiaries | 28 |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2287 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 392 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0844 |