| National Provider Identifier [NPI]: | 1962402727 |
| Last Name Of The Provider | BELTRAN |
| First Name Of The Provider | JAVIER |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 150 NASSAU STREET |
| Street Address 2 Of The Provider | APT 18A |
| City Of The Provider | NEW YORK |
| Zip Code Of The Provider | 100381547 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 4863 |
| Number Of Medicare Beneficiaries | 3273 |
| Total Submitted Charge Amount | 852289.16 |
| Total Medicare Allowed Amount | 273649.66 |
| Total Medicare Payment Amount | 210195.05 |
| Total Medicare Standardized Payment Amount | 184382.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 530 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 1004.8 |
| Total Drug Medicare AllowedAmount | 403.14 |
| Total Drug Medicare PaymentAmount | 261.98 |
| Total Drug Medicare Standardized Payment Amount | 261.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 107 |
| Number Of Medical Services | 4333 |
| Number Of Medicare Beneficiaries With Medical Services | 3273 |
| Total Medical Submitted Charge Amount | 851284.36 |
| Total Medical Medicare Allowed Amount | 273246.52 |
| Total Medical Medicare Payment Amount | 209933.07 |
| Total Medical Medicare Standardized Payment Amount | 184120.56 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 612 |
| Number Of Beneficiaries Age 65 to 74 | 1188 |
| Number Of Beneficiaries Age 75 to 84 | 909 |
| Number Of Beneficiaries Age Greater 84 | 564 |
| Number Of Female Beneficiaries | 2008 |
| Number Of Male Beneficiaries | 1265 |
| Number Of Non Hispanic White Beneficiaries | 2113 |
| Number Of Black or African American Beneficiaries | 209 |
| Number Of AsianPacific Islander Beneficiaries | 143 |
| Number Of Hispanic Beneficiaries | 736 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | 61 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1589 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1684 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.696 |