| National Provider Identifier [NPI]: | 1487632725 |
| Last Name Of The Provider | BALDWIN |
| First Name Of The Provider | MATTHEW |
| 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 | 166 4TH ST E |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT PAUL |
| Zip Code Of The Provider | 551011421 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 153 |
| Number Of Services | 8452 |
| Number Of Medicare Beneficiaries | 2561 |
| Total Submitted Charge Amount | 433911.69 |
| Total Medicare Allowed Amount | 138130.44 |
| Total Medicare Payment Amount | 102274.46 |
| Total Medicare Standardized Payment Amount | 106434.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 4566 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 7001 |
| Total Drug Medicare AllowedAmount | 1207.5 |
| Total Drug Medicare PaymentAmount | 936.42 |
| Total Drug Medicare Standardized Payment Amount | 936.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 149 |
| Number Of Medical Services | 3886 |
| Number Of Medicare Beneficiaries With Medical Services | 2561 |
| Total Medical Submitted Charge Amount | 426910.69 |
| Total Medical Medicare Allowed Amount | 136922.94 |
| Total Medical Medicare Payment Amount | 101338.04 |
| Total Medical Medicare Standardized Payment Amount | 105498.49 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 764 |
| Number Of Beneficiaries Age 65 to 74 | 740 |
| Number Of Beneficiaries Age 75 to 84 | 637 |
| Number Of Beneficiaries Age Greater 84 | 420 |
| Number Of Female Beneficiaries | 1447 |
| Number Of Male Beneficiaries | 1114 |
| Number Of Non Hispanic White Beneficiaries | 2172 |
| Number Of Black or African American Beneficiaries | 210 |
| Number Of AsianPacific Islander Beneficiaries | 52 |
| Number Of Hispanic Beneficiaries | 68 |
| Number Of American Indian Alaska Native Beneficiaries | 17 |
| Number Of Beneficiaries With Race Not Else where Classified | 42 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1685 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 876 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6862 |