| National Provider Identifier [NPI]: | 1043277064 |
| Last Name Of The Provider | BAUMBERGER |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 304 W HAY ST |
| Street Address 2 Of The Provider | STE 312 |
| City Of The Provider | DECATUR |
| Zip Code Of The Provider | 625266328 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 5093 |
| Number Of Medicare Beneficiaries | 799 |
| Total Submitted Charge Amount | 365828.52 |
| Total Medicare Allowed Amount | 226277.38 |
| Total Medicare Payment Amount | 157432.89 |
| Total Medicare Standardized Payment Amount | 163919.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 417 |
| Number Of Medicare Beneficiaries With Drug Services | 254 |
| Total Drug Submitted ChargeAmount | 11684.59 |
| Total Drug Medicare AllowedAmount | 9608.54 |
| Total Drug Medicare PaymentAmount | 9316.52 |
| Total Drug Medicare Standardized Payment Amount | 9316.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 4676 |
| Number Of Medicare Beneficiaries With Medical Services | 799 |
| Total Medical Submitted Charge Amount | 354143.93 |
| Total Medical Medicare Allowed Amount | 216668.84 |
| Total Medical Medicare Payment Amount | 148116.37 |
| Total Medical Medicare Standardized Payment Amount | 154602.55 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 335 |
| Number Of Beneficiaries Age 75 to 84 | 296 |
| Number Of Beneficiaries Age Greater 84 | 145 |
| Number Of Female Beneficiaries | 417 |
| Number Of Male Beneficiaries | 382 |
| Number Of Non Hispanic White Beneficiaries | 728 |
| 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 | 766 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 33 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0522 |