| National Provider Identifier [NPI]: | 1740321371 |
| Last Name Of The Provider | BAUMAN |
| First Name Of The Provider | SHIRLEY |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | PA-C, MPAS |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 629 DEER RIDGE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLARKSVILLE |
| Zip Code Of The Provider | 370427065 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 80 |
| Number Of Medicare Beneficiaries | 68 |
| Total Submitted Charge Amount | 96256 |
| Total Medicare Allowed Amount | 9130.3 |
| Total Medicare Payment Amount | 7158.16 |
| Total Medicare Standardized Payment Amount | 8841.8 |
| 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 | 9 |
| Number Of Medical Services | 80 |
| Number Of Medicare Beneficiaries With Medical Services | 68 |
| Total Medical Submitted Charge Amount | 96256 |
| Total Medical Medicare Allowed Amount | 9130.3 |
| Total Medical Medicare Payment Amount | 7158.16 |
| Total Medical Medicare Standardized Payment Amount | 8841.8 |
| Average Age Of Beneficiaries | 55 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 44 |
| Number Of Male Beneficiaries | 24 |
| Number Of Non Hispanic White Beneficiaries | 54 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 34 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 22 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2498 |