National Provider Identifier [NPI]: |
1023108503 |
Last Name Of The Provider |
BELAND |
First Name Of The Provider |
SUSAN |
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 |
4301 W MARKHAM ST # 783 |
Street Address 2 Of The Provider |
|
City Of The Provider |
LITTLE ROCK |
Zip Code Of The Provider |
722057101 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
1545 |
Number Of Medicare Beneficiaries |
423 |
Total Submitted Charge Amount |
223779 |
Total Medicare Allowed Amount |
125672.5 |
Total Medicare Payment Amount |
96993.01 |
Total Medicare Standardized Payment Amount |
103601.85 |
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 |
22 |
Number Of Medical Services |
1545 |
Number Of Medicare Beneficiaries With Medical Services |
423 |
Total Medical Submitted Charge Amount |
223779 |
Total Medical Medicare Allowed Amount |
125672.5 |
Total Medical Medicare Payment Amount |
96993.01 |
Total Medical Medicare Standardized Payment Amount |
103601.85 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
203 |
Number Of Beneficiaries Age 65 to 74 |
131 |
Number Of Beneficiaries Age 75 to 84 |
57 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
232 |
Number Of Male Beneficiaries |
191 |
Number Of Non Hispanic White Beneficiaries |
261 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
214 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
209 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.4019 |