| National Provider Identifier [NPI]: | 1194060848 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | REBECCA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | CNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1479 N RIVER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FREMONT |
| Zip Code Of The Provider | 434209760 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 990 |
| Number Of Medicare Beneficiaries | 277 |
| Total Submitted Charge Amount | 86629.22 |
| Total Medicare Allowed Amount | 47339.01 |
| Total Medicare Payment Amount | 32831.36 |
| Total Medicare Standardized Payment Amount | 40593.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 58 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 2060 |
| Total Drug Medicare AllowedAmount | 856.32 |
| Total Drug Medicare PaymentAmount | 771.98 |
| Total Drug Medicare Standardized Payment Amount | 771.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 932 |
| Number Of Medicare Beneficiaries With Medical Services | 277 |
| Total Medical Submitted Charge Amount | 84569.22 |
| Total Medical Medicare Allowed Amount | 46482.69 |
| Total Medical Medicare Payment Amount | 32059.38 |
| Total Medical Medicare Standardized Payment Amount | 39821.68 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 158 |
| Number Of Beneficiaries Age 65 to 74 | 67 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 172 |
| Number Of Male Beneficiaries | 105 |
| Number Of Non Hispanic White Beneficiaries | 238 |
| 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 | 144 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 133 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 50 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 25 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1012 |