National Provider Identifier [NPI]: |
1831187772 |
Last Name Of The Provider |
BALDWIN |
First Name Of The Provider |
TANYA |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1020 VARLAND AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TOLEDO |
Zip Code Of The Provider |
436053245 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
61 |
Number Of Services |
2923 |
Number Of Medicare Beneficiaries |
419 |
Total Submitted Charge Amount |
287156 |
Total Medicare Allowed Amount |
185636.62 |
Total Medicare Payment Amount |
138669.92 |
Total Medicare Standardized Payment Amount |
143352.82 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
15 |
Number Of Drug Services |
1226 |
Number Of Medicare Beneficiaries With Drug Services |
162 |
Total Drug Submitted ChargeAmount |
17609 |
Total Drug Medicare AllowedAmount |
9729.44 |
Total Drug Medicare PaymentAmount |
9235.84 |
Total Drug Medicare Standardized Payment Amount |
9235.84 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
1697 |
Number Of Medicare Beneficiaries With Medical Services |
419 |
Total Medical Submitted Charge Amount |
269547 |
Total Medical Medicare Allowed Amount |
175907.18 |
Total Medical Medicare Payment Amount |
129434.08 |
Total Medical Medicare Standardized Payment Amount |
134116.98 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
136 |
Number Of Beneficiaries Age 65 to 74 |
152 |
Number Of Beneficiaries Age 75 to 84 |
90 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
258 |
Number Of Male Beneficiaries |
161 |
Number Of Non Hispanic White Beneficiaries |
338 |
Number Of Black or African American Beneficiaries |
44 |
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 |
251 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
168 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3945 |