| National Provider Identifier [NPI]: | 1154360436 |
| Last Name Of The Provider | BAKER |
| First Name Of The Provider | DUSTIN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7530 NW 23RD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BETHANY |
| Zip Code Of The Provider | 730084921 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 114 |
| Number Of Services | 5046 |
| Number Of Medicare Beneficiaries | 522 |
| Total Submitted Charge Amount | 188771.32 |
| Total Medicare Allowed Amount | 172748.53 |
| Total Medicare Payment Amount | 128026.7 |
| Total Medicare Standardized Payment Amount | 139459.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 434 |
| Number Of Medicare Beneficiaries With Drug Services | 178 |
| Total Drug Submitted ChargeAmount | 8140.05 |
| Total Drug Medicare AllowedAmount | 7691.84 |
| Total Drug Medicare PaymentAmount | 6789.74 |
| Total Drug Medicare Standardized Payment Amount | 6789.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 100 |
| Number Of Medical Services | 4612 |
| Number Of Medicare Beneficiaries With Medical Services | 522 |
| Total Medical Submitted Charge Amount | 180631.27 |
| Total Medical Medicare Allowed Amount | 165056.69 |
| Total Medical Medicare Payment Amount | 121236.96 |
| Total Medical Medicare Standardized Payment Amount | 132669.48 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 73 |
| Number Of Beneficiaries Age 65 to 74 | 199 |
| Number Of Beneficiaries Age 75 to 84 | 159 |
| Number Of Beneficiaries Age Greater 84 | 91 |
| Number Of Female Beneficiaries | 313 |
| Number Of Male Beneficiaries | 209 |
| Number Of Non Hispanic White Beneficiaries | 469 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 433 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 89 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1777 |