The limited scale of the medallion format did not discourage this artisan from including a wealth of narrative details. The obverse shows the Virgin and Child enthroned between angels, with small representations of the Nativity and the Adoration underneath. The reverse narrates the Baptism of Christ. John places his hand on Christ's head, as the dove of the Spirit descends and two angels approach with towels. God's hand appears at the top, the iconic counterpart to the inscription,  houtos estin ho huios mou / ho agapitos en ho eudokesa ("This is my beloved son, with whom I am well pleased," Matt. 3:17). In the water below, two excited male figures emerge from shells while a third reclines with an urn and waves a reed in amazement. These figures are personifications of the Ior and the Dan (the two sources of the Jordan River) and the sea, recalling a verse in the Psalms that Christians associated with the Baptism, "The sea looked and fled, Jordan turned back" (Ps. 113-114:3).

The dating depends on the fact that this medallion was not cast, as others were, but struck like a coin. In all likelihood, then, it was produced, as all gold coinage was, at the imperial mint in Constantinople. It bears a stylistic resemblance to coins minted by Maurice Tiberius (582-602). The choice of the baptism as the main image on the reverse is unusual and may reflect the celebration of an imperial baptism, such as the baptism of Maurice's son and heir apparent Theodosius in 583/584.