| National Provider Identifier [NPI]: | 1790743615 |
| Last Name Of The Provider | BELAND |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 593 EDDY ST |
| Street Address 2 Of The Provider | DEPT OF DIAGNOSTIC IMAGING |
| City Of The Provider | PROVIDENCE |
| Zip Code Of The Provider | 029034923 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 145 |
| Number Of Services | 7424 |
| Number Of Medicare Beneficiaries | 2074 |
| Total Submitted Charge Amount | 477302.5 |
| Total Medicare Allowed Amount | 160192.07 |
| Total Medicare Payment Amount | 120911.42 |
| Total Medicare Standardized Payment Amount | 118097.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 4251 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 4812.5 |
| Total Drug Medicare AllowedAmount | 2123.9 |
| Total Drug Medicare PaymentAmount | 1665.09 |
| Total Drug Medicare Standardized Payment Amount | 1665.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 139 |
| Number Of Medical Services | 3173 |
| Number Of Medicare Beneficiaries With Medical Services | 2074 |
| Total Medical Submitted Charge Amount | 472490 |
| Total Medical Medicare Allowed Amount | 158068.17 |
| Total Medical Medicare Payment Amount | 119246.33 |
| Total Medical Medicare Standardized Payment Amount | 116432.14 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 590 |
| Number Of Beneficiaries Age 65 to 74 | 691 |
| Number Of Beneficiaries Age 75 to 84 | 475 |
| Number Of Beneficiaries Age Greater 84 | 318 |
| Number Of Female Beneficiaries | 1164 |
| Number Of Male Beneficiaries | 910 |
| Number Of Non Hispanic White Beneficiaries | 1546 |
| Number Of Black or African American Beneficiaries | 149 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 283 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 55 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1213 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 861 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8333 |