| National Provider Identifier [NPI]: | 1750388872 |
| Last Name Of The Provider | BELICENA-BADILLO |
| First Name Of The Provider | MARICAR |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 121 BECKS WOODS DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEAR |
| Zip Code Of The Provider | 197013851 |
| State Code Of The Provider | DE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 414 |
| Number Of Medicare Beneficiaries | 149 |
| Total Submitted Charge Amount | 42936 |
| Total Medicare Allowed Amount | 33432.84 |
| Total Medicare Payment Amount | 22800.92 |
| Total Medicare Standardized Payment Amount | 22916.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 32 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 1075 |
| Total Drug Medicare AllowedAmount | 858.11 |
| Total Drug Medicare PaymentAmount | 840.9 |
| Total Drug Medicare Standardized Payment Amount | 840.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 382 |
| Number Of Medicare Beneficiaries With Medical Services | 149 |
| Total Medical Submitted Charge Amount | 41861 |
| Total Medical Medicare Allowed Amount | 32574.73 |
| Total Medical Medicare Payment Amount | 21960.02 |
| Total Medical Medicare Standardized Payment Amount | 22075.35 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 66 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 131 |
| Number Of Male Beneficiaries | 18 |
| Number Of Non Hispanic White Beneficiaries | 77 |
| Number Of Black or African American Beneficiaries | 53 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 89 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 60 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0809 |