| National Provider Identifier [NPI]: | 1811940596 |
| Last Name Of The Provider | BELTRAN |
| First Name Of The Provider | ANTONIO |
| 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 | 10050 SW INNOVATION WAY |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | PORT ST LUCIE |
| Zip Code Of The Provider | 349872117 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 6200 |
| Number Of Medicare Beneficiaries | 1497 |
| Total Submitted Charge Amount | 1623245.74 |
| Total Medicare Allowed Amount | 504388.7 |
| Total Medicare Payment Amount | 379909.23 |
| Total Medicare Standardized Payment Amount | 362746.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 261 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 144884.13 |
| Total Drug Medicare AllowedAmount | 32884.81 |
| Total Drug Medicare PaymentAmount | 25694.56 |
| Total Drug Medicare Standardized Payment Amount | 25694.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 97 |
| Number Of Medical Services | 5939 |
| Number Of Medicare Beneficiaries With Medical Services | 1497 |
| Total Medical Submitted Charge Amount | 1478361.61 |
| Total Medical Medicare Allowed Amount | 471503.89 |
| Total Medical Medicare Payment Amount | 354214.67 |
| Total Medical Medicare Standardized Payment Amount | 337052.04 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 73 |
| Number Of Beneficiaries Age 65 to 74 | 558 |
| Number Of Beneficiaries Age 75 to 84 | 606 |
| Number Of Beneficiaries Age Greater 84 | 260 |
| Number Of Female Beneficiaries | 366 |
| Number Of Male Beneficiaries | 1131 |
| Number Of Non Hispanic White Beneficiaries | 1348 |
| Number Of Black or African American Beneficiaries | 45 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 69 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1415 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 82 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3198 |