| National Provider Identifier [NPI]: | 1154454940 |
| Last Name Of The Provider | BAXTER |
| First Name Of The Provider | MAUREEN |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9205 SW BARNES RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 972256603 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 1501.5 |
| Number Of Medicare Beneficiaries | 924 |
| Total Submitted Charge Amount | 156708.5 |
| Total Medicare Allowed Amount | 51170.88 |
| Total Medicare Payment Amount | 42924.07 |
| Total Medicare Standardized Payment Amount | 42840.78 |
| Drug Suppress Indicator | * |
| Number Of HCPCS Associated With Drug Services | |
| Number Of Drug Services | |
| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
| Total Drug Medicare AllowedAmount | |
| Total Drug Medicare PaymentAmount | |
| Total Drug Medicare Standardized Payment Amount | |
| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
| Number Of Medical Services | |
| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
| Total Medical Medicare Payment Amount | |
| Total Medical Medicare Standardized Payment Amount | |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 126 |
| Number Of Beneficiaries Age 65 to 74 | 427 |
| Number Of Beneficiaries Age 75 to 84 | 240 |
| Number Of Beneficiaries Age Greater 84 | 131 |
| Number Of Female Beneficiaries | 723 |
| Number Of Male Beneficiaries | 201 |
| Number Of Non Hispanic White Beneficiaries | 832 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 37 |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 739 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 185 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3447 |