| National Provider Identifier [NPI]: | 1467529701 |
| Last Name Of The Provider | BALDWIN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 SAINT PAUL STREET |
| Street Address 2 Of The Provider | UNIT 102 |
| City Of The Provider | BROOKLINE |
| Zip Code Of The Provider | 02446 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 156 |
| Number Of Services | 7272 |
| Number Of Medicare Beneficiaries | 2509 |
| Total Submitted Charge Amount | 678901 |
| Total Medicare Allowed Amount | 157747.31 |
| Total Medicare Payment Amount | 117940.79 |
| Total Medicare Standardized Payment Amount | 112232.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 3337 |
| Number Of Medicare Beneficiaries With Drug Services | 84 |
| Total Drug Submitted ChargeAmount | 10453 |
| Total Drug Medicare AllowedAmount | 1029.74 |
| Total Drug Medicare PaymentAmount | 784.38 |
| Total Drug Medicare Standardized Payment Amount | 784.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 152 |
| Number Of Medical Services | 3935 |
| Number Of Medicare Beneficiaries With Medical Services | 2508 |
| Total Medical Submitted Charge Amount | 668448 |
| Total Medical Medicare Allowed Amount | 156717.57 |
| Total Medical Medicare Payment Amount | 117156.41 |
| Total Medical Medicare Standardized Payment Amount | 111448.21 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 484 |
| Number Of Beneficiaries Age 65 to 74 | 738 |
| Number Of Beneficiaries Age 75 to 84 | 769 |
| Number Of Beneficiaries Age Greater 84 | 518 |
| Number Of Female Beneficiaries | 1458 |
| Number Of Male Beneficiaries | 1051 |
| Number Of Non Hispanic White Beneficiaries | 2164 |
| Number Of Black or African American Beneficiaries | 80 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 212 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1544 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 965 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7781 |