National Provider Identifier [NPI]: |
1386654366 |
Last Name Of The Provider |
BELK |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2070 CLINTON AVE |
Street Address 2 Of The Provider |
5TH FLOOR |
City Of The Provider |
ALAMEDA |
Zip Code Of The Provider |
945014320 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
764 |
Number Of Medicare Beneficiaries |
248 |
Total Submitted Charge Amount |
67415 |
Total Medicare Allowed Amount |
53817.41 |
Total Medicare Payment Amount |
34204.23 |
Total Medicare Standardized Payment Amount |
29956.78 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
99 |
Number Of Medicare Beneficiaries With Drug Services |
83 |
Total Drug Submitted ChargeAmount |
2810 |
Total Drug Medicare AllowedAmount |
1740.99 |
Total Drug Medicare PaymentAmount |
1698.01 |
Total Drug Medicare Standardized Payment Amount |
1698.01 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
665 |
Number Of Medicare Beneficiaries With Medical Services |
248 |
Total Medical Submitted Charge Amount |
64605 |
Total Medical Medicare Allowed Amount |
52076.42 |
Total Medical Medicare Payment Amount |
32506.22 |
Total Medical Medicare Standardized Payment Amount |
28258.77 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
105 |
Number Of Beneficiaries Age 75 to 84 |
82 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
124 |
Number Of Male Beneficiaries |
124 |
Number Of Non Hispanic White Beneficiaries |
162 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
42 |
Number Of Hispanic Beneficiaries |
24 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
205 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
43 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
|
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
8 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
21 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9737 |