| National Provider Identifier [NPI]: | 1770895799 |
| Last Name Of The Provider | BALTEN |
| First Name Of The Provider | EMILY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | PAC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 33155 ANNAPOLIS ST |
| Street Address 2 Of The Provider | EMERGENCY MEDICINE DEPARTMENT |
| City Of The Provider | WAYNE |
| Zip Code Of The Provider | 481842405 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 8781 |
| Number Of Medicare Beneficiaries | 821 |
| Total Submitted Charge Amount | 671231.55 |
| Total Medicare Allowed Amount | 341012.28 |
| Total Medicare Payment Amount | 266871.18 |
| Total Medicare Standardized Payment Amount | 301553.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1058 |
| Number Of Medicare Beneficiaries With Drug Services | 278 |
| Total Drug Submitted ChargeAmount | 3667 |
| Total Drug Medicare AllowedAmount | 1918.32 |
| Total Drug Medicare PaymentAmount | 1503.04 |
| Total Drug Medicare Standardized Payment Amount | 1503.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 7723 |
| Number Of Medicare Beneficiaries With Medical Services | 821 |
| Total Medical Submitted Charge Amount | 667564.55 |
| Total Medical Medicare Allowed Amount | 339093.96 |
| Total Medical Medicare Payment Amount | 265368.14 |
| Total Medical Medicare Standardized Payment Amount | 300050.61 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 87 |
| Number Of Beneficiaries Age 65 to 74 | 160 |
| Number Of Beneficiaries Age 75 to 84 | 242 |
| Number Of Beneficiaries Age Greater 84 | 332 |
| Number Of Female Beneficiaries | 555 |
| Number Of Male Beneficiaries | 266 |
| Number Of Non Hispanic White Beneficiaries | 629 |
| Number Of Black or African American Beneficiaries | 166 |
| 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 | 118 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 703 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 61 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 61 |
| Percent Of With Diabetes | 63 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 26 |
| Percent Of With Stroke | 27 |
| Average HCC Risk Score Of Beneficiaries | 2.8964 |