| National Provider Identifier [NPI]: | 1780750885 |
| Last Name Of The Provider | BALDWIN |
| First Name Of The Provider | JEREMY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12720 MCMANUS BLVD |
| Street Address 2 Of The Provider | SUITE 203 |
| City Of The Provider | NEWPORT NEWS |
| Zip Code Of The Provider | 236024414 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 3009 |
| Number Of Medicare Beneficiaries | 604 |
| Total Submitted Charge Amount | 479141 |
| Total Medicare Allowed Amount | 196639.01 |
| Total Medicare Payment Amount | 151108.04 |
| Total Medicare Standardized Payment Amount | 153849.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 56 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 1926 |
| Total Drug Medicare AllowedAmount | 960.98 |
| Total Drug Medicare PaymentAmount | 903.03 |
| Total Drug Medicare Standardized Payment Amount | 903.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 2953 |
| Number Of Medicare Beneficiaries With Medical Services | 604 |
| Total Medical Submitted Charge Amount | 477215 |
| Total Medical Medicare Allowed Amount | 195678.03 |
| Total Medical Medicare Payment Amount | 150205.01 |
| Total Medical Medicare Standardized Payment Amount | 152946.28 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 198 |
| Number Of Beneficiaries Age 75 to 84 | 205 |
| Number Of Beneficiaries Age Greater 84 | 126 |
| Number Of Female Beneficiaries | 344 |
| Number Of Male Beneficiaries | 260 |
| Number Of Non Hispanic White Beneficiaries | 435 |
| Number Of Black or African American Beneficiaries | 137 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| 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 | 507 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 97 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.7975 |