| National Provider Identifier [NPI]: | 1154489839 |
| Last Name Of The Provider | BELLIDO |
| First Name Of The Provider | ALEX |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2051 PREVATT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | EUSTIS |
| Zip Code Of The Provider | 327266141 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 6728 |
| Number Of Medicare Beneficiaries | 883 |
| Total Submitted Charge Amount | 915304 |
| Total Medicare Allowed Amount | 578639.93 |
| Total Medicare Payment Amount | 427795.51 |
| Total Medicare Standardized Payment Amount | 429348.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 414 |
| Number Of Medicare Beneficiaries With Drug Services | 340 |
| Total Drug Submitted ChargeAmount | 18750 |
| Total Drug Medicare AllowedAmount | 12108.17 |
| Total Drug Medicare PaymentAmount | 11843.51 |
| Total Drug Medicare Standardized Payment Amount | 11843.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 6314 |
| Number Of Medicare Beneficiaries With Medical Services | 883 |
| Total Medical Submitted Charge Amount | 896554 |
| Total Medical Medicare Allowed Amount | 566531.76 |
| Total Medical Medicare Payment Amount | 415952 |
| Total Medical Medicare Standardized Payment Amount | 417505.27 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 328 |
| Number Of Beneficiaries Age 75 to 84 | 345 |
| Number Of Beneficiaries Age Greater 84 | 182 |
| Number Of Female Beneficiaries | 490 |
| Number Of Male Beneficiaries | 393 |
| Number Of Non Hispanic White Beneficiaries | 810 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 813 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3275 |