National Provider Identifier [NPI]: |
1629114814 |
Last Name Of The Provider |
BELAN |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2303 WILLOW VALE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
FALLSTON |
Zip Code Of The Provider |
210471504 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
77 |
Number Of Services |
394 |
Number Of Medicare Beneficiaries |
324 |
Total Submitted Charge Amount |
546912.44 |
Total Medicare Allowed Amount |
53022.35 |
Total Medicare Payment Amount |
41454.21 |
Total Medicare Standardized Payment Amount |
40358.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
77 |
Number Of Medical Services |
394 |
Number Of Medicare Beneficiaries With Medical Services |
324 |
Total Medical Submitted Charge Amount |
546912.44 |
Total Medical Medicare Allowed Amount |
53022.35 |
Total Medical Medicare Payment Amount |
41454.21 |
Total Medical Medicare Standardized Payment Amount |
40358.01 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
123 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
167 |
Number Of Male Beneficiaries |
157 |
Number Of Non Hispanic White Beneficiaries |
297 |
Number Of Black or African American Beneficiaries |
16 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
266 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.7183 |