| National Provider Identifier [NPI]: | 1720073596 |
| Last Name Of The Provider | BALDRIDGE |
| First Name Of The Provider | BYRON |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2300 12TH AVE S |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | GREAT FALLS |
| Zip Code Of The Provider | 594055017 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 6869 |
| Number Of Medicare Beneficiaries | 1162 |
| Total Submitted Charge Amount | 1019981 |
| Total Medicare Allowed Amount | 456443.45 |
| Total Medicare Payment Amount | 324291.02 |
| Total Medicare Standardized Payment Amount | 319132.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 39 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 6145 |
| Total Drug Medicare AllowedAmount | 4219.69 |
| Total Drug Medicare PaymentAmount | 3293.77 |
| Total Drug Medicare Standardized Payment Amount | 3293.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 79 |
| Number Of Medical Services | 6830 |
| Number Of Medicare Beneficiaries With Medical Services | 1162 |
| Total Medical Submitted Charge Amount | 1013836 |
| Total Medical Medicare Allowed Amount | 452223.76 |
| Total Medical Medicare Payment Amount | 320997.25 |
| Total Medical Medicare Standardized Payment Amount | 315838.79 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 468 |
| Number Of Beneficiaries Age 75 to 84 | 440 |
| Number Of Beneficiaries Age Greater 84 | 224 |
| Number Of Female Beneficiaries | 547 |
| Number Of Male Beneficiaries | 615 |
| Number Of Non Hispanic White Beneficiaries | 1129 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1119 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0185 |