| National Provider Identifier [NPI]: | 1063474971 |
| Last Name Of The Provider | BAXLEY |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 403 PARKWAY DRIVE |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | GREENSBORO |
| Zip Code Of The Provider | 27401 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 796 |
| Number Of Medicare Beneficiaries | 132 |
| Total Submitted Charge Amount | 96397.3 |
| Total Medicare Allowed Amount | 44347.59 |
| Total Medicare Payment Amount | 33380.24 |
| Total Medicare Standardized Payment Amount | 35767.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 153 |
| Number Of Medicare Beneficiaries With Drug Services | 67 |
| Total Drug Submitted ChargeAmount | 4494 |
| Total Drug Medicare AllowedAmount | 1394.6 |
| Total Drug Medicare PaymentAmount | 1329.15 |
| Total Drug Medicare Standardized Payment Amount | 1329.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 643 |
| Number Of Medicare Beneficiaries With Medical Services | 132 |
| Total Medical Submitted Charge Amount | 91903.3 |
| Total Medical Medicare Allowed Amount | 42952.99 |
| Total Medical Medicare Payment Amount | 32051.09 |
| Total Medical Medicare Standardized Payment Amount | 34438.73 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 61 |
| Number Of Beneficiaries Age 75 to 84 | 36 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 104 |
| Number Of Male Beneficiaries | 28 |
| Number Of Non Hispanic White Beneficiaries | 119 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8364 |