| National Provider Identifier [NPI]: | 1437248853 |
| Last Name Of The Provider | BELLON |
| First Name Of The Provider | LANA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4516 N ARMENIA AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336032732 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 207 |
| Number Of Services | 20351 |
| Number Of Medicare Beneficiaries | 3087 |
| Total Submitted Charge Amount | 1289194 |
| Total Medicare Allowed Amount | 323352.8 |
| Total Medicare Payment Amount | 247663.35 |
| Total Medicare Standardized Payment Amount | 254074.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 15896 |
| Number Of Medicare Beneficiaries With Drug Services | 185 |
| Total Drug Submitted ChargeAmount | 35030 |
| Total Drug Medicare AllowedAmount | 4853.71 |
| Total Drug Medicare PaymentAmount | 3790.1 |
| Total Drug Medicare Standardized Payment Amount | 3790.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 202 |
| Number Of Medical Services | 4455 |
| Number Of Medicare Beneficiaries With Medical Services | 3083 |
| Total Medical Submitted Charge Amount | 1254164 |
| Total Medical Medicare Allowed Amount | 318499.09 |
| Total Medical Medicare Payment Amount | 243873.25 |
| Total Medical Medicare Standardized Payment Amount | 250284.87 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 501 |
| Number Of Beneficiaries Age 65 to 74 | 1044 |
| Number Of Beneficiaries Age 75 to 84 | 897 |
| Number Of Beneficiaries Age Greater 84 | 645 |
| Number Of Female Beneficiaries | 1929 |
| Number Of Male Beneficiaries | 1158 |
| Number Of Non Hispanic White Beneficiaries | 2064 |
| Number Of Black or African American Beneficiaries | 387 |
| Number Of AsianPacific Islander Beneficiaries | 37 |
| Number Of Hispanic Beneficiaries | 568 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2079 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1008 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.9733 |