| National Provider Identifier [NPI]: | 1033290978 |
| Last Name Of The Provider | BALDWIN |
| First Name Of The Provider | FRED |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | P.A. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 711 ONYX ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | KEMMERER |
| Zip Code Of The Provider | 831013214 |
| State Code Of The Provider | WY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 407 |
| Number Of Medicare Beneficiaries | 182 |
| Total Submitted Charge Amount | 38798 |
| Total Medicare Allowed Amount | 25461.5 |
| Total Medicare Payment Amount | 14978.6 |
| Total Medicare Standardized Payment Amount | 18706.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 45 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 709 |
| Total Drug Medicare AllowedAmount | 114.11 |
| Total Drug Medicare PaymentAmount | 80.3 |
| Total Drug Medicare Standardized Payment Amount | 80.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 362 |
| Number Of Medicare Beneficiaries With Medical Services | 182 |
| Total Medical Submitted Charge Amount | 38089 |
| Total Medical Medicare Allowed Amount | 25347.39 |
| Total Medical Medicare Payment Amount | 14898.3 |
| Total Medical Medicare Standardized Payment Amount | 18626.04 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 91 |
| Number Of Beneficiaries Age 75 to 84 | 49 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 100 |
| Number Of Male Beneficiaries | 82 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 169 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 20 |
| Percent Of With Hypertension | 38 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7997 |