| National Provider Identifier [NPI]: | 1164626289 |
| Last Name Of The Provider | BAKER |
| First Name Of The Provider | JESSICA |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 176 S NEW MIDDLETOWN RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MEDIA |
| Zip Code Of The Provider | 190635255 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 582 |
| Number Of Medicare Beneficiaries | 162 |
| Total Submitted Charge Amount | 68744 |
| Total Medicare Allowed Amount | 49399.61 |
| Total Medicare Payment Amount | 35189.21 |
| Total Medicare Standardized Payment Amount | 33489.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 49 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 1635 |
| Total Drug Medicare AllowedAmount | 1351.8 |
| Total Drug Medicare PaymentAmount | 1323.87 |
| Total Drug Medicare Standardized Payment Amount | 1323.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 533 |
| Number Of Medicare Beneficiaries With Medical Services | 162 |
| Total Medical Submitted Charge Amount | 67109 |
| Total Medical Medicare Allowed Amount | 48047.81 |
| Total Medical Medicare Payment Amount | 33865.34 |
| Total Medical Medicare Standardized Payment Amount | 32165.98 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 74 |
| Number Of Beneficiaries Age 75 to 84 | 26 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 105 |
| Number Of Male Beneficiaries | 57 |
| Number Of Non Hispanic White Beneficiaries | 148 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 128 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0931 |