| National Provider Identifier [NPI]: | 1659347425 |
| Last Name Of The Provider | BELANUS |
| First Name Of The Provider | EMILY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 520 SOUTH SIBLEY AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LITCHFIELD |
| Zip Code Of The Provider | 55355 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 397 |
| Number Of Medicare Beneficiaries | 121 |
| Total Submitted Charge Amount | 38087.21 |
| Total Medicare Allowed Amount | 14339.45 |
| Total Medicare Payment Amount | 10582.76 |
| Total Medicare Standardized Payment Amount | 12726.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 249.01 |
| Total Drug Medicare AllowedAmount | 156.02 |
| Total Drug Medicare PaymentAmount | 150.44 |
| Total Drug Medicare Standardized Payment Amount | 150.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 371 |
| Number Of Medicare Beneficiaries With Medical Services | 121 |
| Total Medical Submitted Charge Amount | 37838.2 |
| Total Medical Medicare Allowed Amount | 14183.43 |
| Total Medical Medicare Payment Amount | 10432.32 |
| Total Medical Medicare Standardized Payment Amount | 12576.03 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 25 |
| Number Of Beneficiaries Age 75 to 84 | 30 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 62 |
| Number Of Male Beneficiaries | 59 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 64 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 57 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1447 |