| National Provider Identifier [NPI]: | 1689780876 |
| Last Name Of The Provider | BELFER |
| First Name Of The Provider | EVAN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 801 N 14TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MURPHYSBORO |
| Zip Code Of The Provider | 62966 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 1690 |
| Number Of Medicare Beneficiaries | 357 |
| Total Submitted Charge Amount | 130527.86 |
| Total Medicare Allowed Amount | 114450.04 |
| Total Medicare Payment Amount | 78923.4 |
| Total Medicare Standardized Payment Amount | 84476.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 56 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 755 |
| Total Drug Medicare AllowedAmount | 143.58 |
| Total Drug Medicare PaymentAmount | 97.68 |
| Total Drug Medicare Standardized Payment Amount | 97.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 1634 |
| Number Of Medicare Beneficiaries With Medical Services | 357 |
| Total Medical Submitted Charge Amount | 129772.86 |
| Total Medical Medicare Allowed Amount | 114306.46 |
| Total Medical Medicare Payment Amount | 78825.72 |
| Total Medical Medicare Standardized Payment Amount | 84378.4 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 45 |
| Number Of Beneficiaries Age 65 to 74 | 189 |
| Number Of Beneficiaries Age 75 to 84 | 83 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 186 |
| Number Of Male Beneficiaries | 171 |
| Number Of Non Hispanic White Beneficiaries | 341 |
| 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 | 310 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8483 |