| National Provider Identifier [NPI]: | 1518964873 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1110 DRUID CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAKE WALES |
| Zip Code Of The Provider | 338534307 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 3636 |
| Number Of Medicare Beneficiaries | 459 |
| Total Submitted Charge Amount | 520748 |
| Total Medicare Allowed Amount | 270027.03 |
| Total Medicare Payment Amount | 197405.06 |
| Total Medicare Standardized Payment Amount | 195436.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 226 |
| Number Of Medicare Beneficiaries With Drug Services | 169 |
| Total Drug Submitted ChargeAmount | 3179.28 |
| Total Drug Medicare AllowedAmount | 2234.95 |
| Total Drug Medicare PaymentAmount | 2056.98 |
| Total Drug Medicare Standardized Payment Amount | 2056.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 3410 |
| Number Of Medicare Beneficiaries With Medical Services | 459 |
| Total Medical Submitted Charge Amount | 517568.72 |
| Total Medical Medicare Allowed Amount | 267792.08 |
| Total Medical Medicare Payment Amount | 195348.08 |
| Total Medical Medicare Standardized Payment Amount | 193379.4 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 132 |
| Number Of Beneficiaries Age 75 to 84 | 175 |
| Number Of Beneficiaries Age Greater 84 | 111 |
| Number Of Female Beneficiaries | 253 |
| Number Of Male Beneficiaries | 206 |
| Number Of Non Hispanic White Beneficiaries | 433 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 410 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4173 |