| National Provider Identifier [NPI]: | 1053376061 |
| Last Name Of The Provider | BELIS |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12670 CREEKSIDE LANE |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 33919 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 157 |
| Number Of Services | 4717 |
| Number Of Medicare Beneficiaries | 578 |
| Total Submitted Charge Amount | 1029189.46 |
| Total Medicare Allowed Amount | 381130.16 |
| Total Medicare Payment Amount | 286543.6 |
| Total Medicare Standardized Payment Amount | 271535.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 415 |
| Number Of Medicare Beneficiaries With Drug Services | 98 |
| Total Drug Submitted ChargeAmount | 2364.63 |
| Total Drug Medicare AllowedAmount | 568.48 |
| Total Drug Medicare PaymentAmount | 437.25 |
| Total Drug Medicare Standardized Payment Amount | 437.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 155 |
| Number Of Medical Services | 4302 |
| Number Of Medicare Beneficiaries With Medical Services | 578 |
| Total Medical Submitted Charge Amount | 1026824.83 |
| Total Medical Medicare Allowed Amount | 380561.68 |
| Total Medical Medicare Payment Amount | 286106.35 |
| Total Medical Medicare Standardized Payment Amount | 271098.07 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 45 |
| Number Of Beneficiaries Age 65 to 74 | 286 |
| Number Of Beneficiaries Age 75 to 84 | 178 |
| Number Of Beneficiaries Age Greater 84 | 69 |
| Number Of Female Beneficiaries | 327 |
| Number Of Male Beneficiaries | 251 |
| Number Of Non Hispanic White Beneficiaries | 537 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 552 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1587 |