| National Provider Identifier [NPI]: | 1619946811 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6405 FRANCE AVE S |
| Street Address 2 Of The Provider | SUITE W460 |
| City Of The Provider | EDINA |
| Zip Code Of The Provider | 554352163 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Plastic and Reconstructive Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 4055 |
| Number Of Medicare Beneficiaries | 230 |
| Total Submitted Charge Amount | 251263.29 |
| Total Medicare Allowed Amount | 189021.21 |
| Total Medicare Payment Amount | 142488.49 |
| Total Medicare Standardized Payment Amount | 125582.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 3301 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 21358 |
| Total Drug Medicare AllowedAmount | 18169.31 |
| Total Drug Medicare PaymentAmount | 13111.8 |
| Total Drug Medicare Standardized Payment Amount | 13111.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 754 |
| Number Of Medicare Beneficiaries With Medical Services | 230 |
| Total Medical Submitted Charge Amount | 229905.29 |
| Total Medical Medicare Allowed Amount | 170851.9 |
| Total Medical Medicare Payment Amount | 129376.69 |
| Total Medical Medicare Standardized Payment Amount | 112470.83 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 88 |
| Number Of Beneficiaries Age 75 to 84 | 81 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 156 |
| Number Of Male Beneficiaries | 74 |
| 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 | 207 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.994 |