| National Provider Identifier [NPI]: | 1457593162 |
| Last Name Of The Provider | BELKEN |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 18161 W 13 MILE RD |
| Street Address 2 Of The Provider | SUITE D2 |
| City Of The Provider | SOUTHFIELD |
| Zip Code Of The Provider | 480761113 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 1740 |
| Number Of Medicare Beneficiaries | 511 |
| Total Submitted Charge Amount | 200795 |
| Total Medicare Allowed Amount | 111900.03 |
| Total Medicare Payment Amount | 81332.82 |
| Total Medicare Standardized Payment Amount | 80172.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 97 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 485 |
| Total Drug Medicare AllowedAmount | 13.13 |
| Total Drug Medicare PaymentAmount | 9.18 |
| Total Drug Medicare Standardized Payment Amount | 9.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 1643 |
| Number Of Medicare Beneficiaries With Medical Services | 511 |
| Total Medical Submitted Charge Amount | 200310 |
| Total Medical Medicare Allowed Amount | 111886.9 |
| Total Medical Medicare Payment Amount | 81323.64 |
| Total Medical Medicare Standardized Payment Amount | 80163.47 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 87 |
| Number Of Beneficiaries Age 65 to 74 | 169 |
| Number Of Beneficiaries Age 75 to 84 | 142 |
| Number Of Beneficiaries Age Greater 84 | 113 |
| Number Of Female Beneficiaries | 286 |
| Number Of Male Beneficiaries | 225 |
| Number Of Non Hispanic White Beneficiaries | 345 |
| Number Of Black or African American Beneficiaries | 152 |
| 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 | 420 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 91 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6828 |