| National Provider Identifier [NPI]: | 1306807748 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | MICHELLE |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 LILE CT |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | LITTLE ROCK |
| Zip Code Of The Provider | 722056242 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 3258 |
| Number Of Medicare Beneficiaries | 1184 |
| Total Submitted Charge Amount | 607739.08 |
| Total Medicare Allowed Amount | 174824.22 |
| Total Medicare Payment Amount | 132812.12 |
| Total Medicare Standardized Payment Amount | 108941.75 |
| 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 | 34 |
| Number Of Medical Services | 3258 |
| Number Of Medicare Beneficiaries With Medical Services | 1184 |
| Total Medical Submitted Charge Amount | 607739.08 |
| Total Medical Medicare Allowed Amount | 174824.22 |
| Total Medical Medicare Payment Amount | 132812.12 |
| Total Medical Medicare Standardized Payment Amount | 108941.75 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 218 |
| Number Of Beneficiaries Age 65 to 74 | 627 |
| Number Of Beneficiaries Age 75 to 84 | 293 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 787 |
| Number Of Male Beneficiaries | 397 |
| Number Of Non Hispanic White Beneficiaries | 1024 |
| Number Of Black or African American Beneficiaries | 114 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 22 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 994 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 190 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9874 |