National Provider Identifier [NPI]: |
1053592162 |
Last Name Of The Provider |
NELSON |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3720 NW 83RD ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
GAINESVILLE |
Zip Code Of The Provider |
326065603 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
1575 |
Number Of Medicare Beneficiaries |
333 |
Total Submitted Charge Amount |
295570.03 |
Total Medicare Allowed Amount |
138683.71 |
Total Medicare Payment Amount |
109153.34 |
Total Medicare Standardized Payment Amount |
109769.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
1575 |
Number Of Medicare Beneficiaries With Medical Services |
333 |
Total Medical Submitted Charge Amount |
295570.03 |
Total Medical Medicare Allowed Amount |
138683.71 |
Total Medical Medicare Payment Amount |
109153.34 |
Total Medical Medicare Standardized Payment Amount |
109769.44 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
119 |
Number Of Beneficiaries Age 75 to 84 |
137 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
178 |
Number Of Male Beneficiaries |
155 |
Number Of Non Hispanic White Beneficiaries |
298 |
Number Of Black or African American Beneficiaries |
24 |
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 |
316 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
17 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.2155 |