National Provider Identifier [NPI]: |
1902110778 |
Last Name Of The Provider |
BELLO |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
540 UNION BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WEST ISLIP |
Zip Code Of The Provider |
117953105 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
1275 |
Number Of Medicare Beneficiaries |
709 |
Total Submitted Charge Amount |
380577 |
Total Medicare Allowed Amount |
150641.6 |
Total Medicare Payment Amount |
117787.61 |
Total Medicare Standardized Payment Amount |
104993.57 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
1275 |
Number Of Medicare Beneficiaries With Medical Services |
709 |
Total Medical Submitted Charge Amount |
380577 |
Total Medical Medicare Allowed Amount |
150641.6 |
Total Medical Medicare Payment Amount |
117787.61 |
Total Medical Medicare Standardized Payment Amount |
104993.57 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
196 |
Number Of Beneficiaries Age 75 to 84 |
247 |
Number Of Beneficiaries Age Greater 84 |
189 |
Number Of Female Beneficiaries |
387 |
Number Of Male Beneficiaries |
322 |
Number Of Non Hispanic White Beneficiaries |
585 |
Number Of Black or African American Beneficiaries |
63 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
44 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
554 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
155 |
Percent Of With Atrial Fibrillation |
35 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.147 |