| National Provider Identifier [NPI]: | 1548284516 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | CAMILLE |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 350 COUNTRY CLUB DRIVE |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | STOCKBRIDGE |
| Zip Code Of The Provider | 30281 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 2768 |
| Number Of Medicare Beneficiaries | 954 |
| Total Submitted Charge Amount | 574456 |
| Total Medicare Allowed Amount | 250619.26 |
| Total Medicare Payment Amount | 189559.89 |
| Total Medicare Standardized Payment Amount | 188318.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 275 |
| Number Of Medicare Beneficiaries With Drug Services | 63 |
| Total Drug Submitted ChargeAmount | 34685 |
| Total Drug Medicare AllowedAmount | 12607.53 |
| Total Drug Medicare PaymentAmount | 9887.11 |
| Total Drug Medicare Standardized Payment Amount | 9887.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 2493 |
| Number Of Medicare Beneficiaries With Medical Services | 954 |
| Total Medical Submitted Charge Amount | 539771 |
| Total Medical Medicare Allowed Amount | 238011.73 |
| Total Medical Medicare Payment Amount | 179672.78 |
| Total Medical Medicare Standardized Payment Amount | 178430.99 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 164 |
| Number Of Beneficiaries Age 65 to 74 | 386 |
| Number Of Beneficiaries Age 75 to 84 | 283 |
| Number Of Beneficiaries Age Greater 84 | 121 |
| Number Of Female Beneficiaries | 560 |
| Number Of Male Beneficiaries | 394 |
| Number Of Non Hispanic White Beneficiaries | 422 |
| Number Of Black or African American Beneficiaries | 481 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| 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 | 686 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 268 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9529 |