| National Provider Identifier [NPI]: | 1144225657 |
| Last Name Of The Provider | BALDOCK |
| First Name Of The Provider | KIMBERLY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1816 CARTER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ASHLAND |
| Zip Code Of The Provider | 411017643 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 2628 |
| Number Of Medicare Beneficiaries | 378 |
| Total Submitted Charge Amount | 373843 |
| Total Medicare Allowed Amount | 185119 |
| Total Medicare Payment Amount | 135346.59 |
| Total Medicare Standardized Payment Amount | 149190.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 254 |
| Number Of Medicare Beneficiaries With Drug Services | 167 |
| Total Drug Submitted ChargeAmount | 7246 |
| Total Drug Medicare AllowedAmount | 3871.84 |
| Total Drug Medicare PaymentAmount | 3677.85 |
| Total Drug Medicare Standardized Payment Amount | 3677.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 2374 |
| Number Of Medicare Beneficiaries With Medical Services | 378 |
| Total Medical Submitted Charge Amount | 366597 |
| Total Medical Medicare Allowed Amount | 181247.16 |
| Total Medical Medicare Payment Amount | 131668.74 |
| Total Medical Medicare Standardized Payment Amount | 145512.89 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 181 |
| Number Of Beneficiaries Age 75 to 84 | 100 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 251 |
| Number Of Male Beneficiaries | 127 |
| 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 | 362 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0309 |