| National Provider Identifier [NPI]: | 1396716437 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | HOWARD |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 700 NE 87TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | VANCOUVER |
| Zip Code Of The Provider | 986641913 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 130 |
| Number Of Services | 18403 |
| Number Of Medicare Beneficiaries | 1724 |
| Total Submitted Charge Amount | 1044586.37 |
| Total Medicare Allowed Amount | 339080.48 |
| Total Medicare Payment Amount | 263508.08 |
| Total Medicare Standardized Payment Amount | 265271.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 15632 |
| Number Of Medicare Beneficiaries With Drug Services | 121 |
| Total Drug Submitted ChargeAmount | 3751.68 |
| Total Drug Medicare AllowedAmount | 3090.41 |
| Total Drug Medicare PaymentAmount | 2358.47 |
| Total Drug Medicare Standardized Payment Amount | 2358.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 129 |
| Number Of Medical Services | 2771 |
| Number Of Medicare Beneficiaries With Medical Services | 1724 |
| Total Medical Submitted Charge Amount | 1040834.69 |
| Total Medical Medicare Allowed Amount | 335990.07 |
| Total Medical Medicare Payment Amount | 261149.61 |
| Total Medical Medicare Standardized Payment Amount | 262912.8 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 285 |
| Number Of Beneficiaries Age 65 to 74 | 725 |
| Number Of Beneficiaries Age 75 to 84 | 482 |
| Number Of Beneficiaries Age Greater 84 | 232 |
| Number Of Female Beneficiaries | 1191 |
| Number Of Male Beneficiaries | 533 |
| Number Of Non Hispanic White Beneficiaries | 1565 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | 13 |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1358 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 366 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2587 |