| National Provider Identifier [NPI]: | 1922007764 |
| Last Name Of The Provider | LECLERCQ |
| First Name Of The Provider | BAUDOUIN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2980 SE 3RD CT |
| Street Address 2 Of The Provider | |
| City Of The Provider | OCALA |
| Zip Code Of The Provider | 344710421 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 13200 |
| Number Of Medicare Beneficiaries | 394 |
| Total Submitted Charge Amount | 5816184.18 |
| Total Medicare Allowed Amount | 1516334.38 |
| Total Medicare Payment Amount | 1162222.01 |
| Total Medicare Standardized Payment Amount | 1216822.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 10665 |
| Number Of Medicare Beneficiaries With Drug Services | 311 |
| Total Drug Submitted ChargeAmount | 25596 |
| Total Drug Medicare AllowedAmount | 1860.81 |
| Total Drug Medicare PaymentAmount | 1454.77 |
| Total Drug Medicare Standardized Payment Amount | 1454.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 2535 |
| Number Of Medicare Beneficiaries With Medical Services | 394 |
| Total Medical Submitted Charge Amount | 5790588.18 |
| Total Medical Medicare Allowed Amount | 1514473.57 |
| Total Medical Medicare Payment Amount | 1160767.24 |
| Total Medical Medicare Standardized Payment Amount | 1215368.13 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 158 |
| Number Of Beneficiaries Age 65 to 74 | 109 |
| Number Of Beneficiaries Age 75 to 84 | 103 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 157 |
| Number Of Male Beneficiaries | 237 |
| Number Of Non Hispanic White Beneficiaries | 234 |
| Number Of Black or African American Beneficiaries | 117 |
| 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 | 238 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 156 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 62 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 75 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 8.1822 |