| National Provider Identifier [NPI]: | 1912928532 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1949 GUNBARREL RD |
| Street Address 2 Of The Provider | STE 170 |
| City Of The Provider | CHATTANOOGA |
| Zip Code Of The Provider | 374213188 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 218 |
| Number Of Services | 45580 |
| Number Of Medicare Beneficiaries | 2765 |
| Total Submitted Charge Amount | 2794502.19 |
| Total Medicare Allowed Amount | 613579.01 |
| Total Medicare Payment Amount | 481598.74 |
| Total Medicare Standardized Payment Amount | 520140.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 40847 |
| Number Of Medicare Beneficiaries With Drug Services | 414 |
| Total Drug Submitted ChargeAmount | 90386.36 |
| Total Drug Medicare AllowedAmount | 11865.87 |
| Total Drug Medicare PaymentAmount | 9220.85 |
| Total Drug Medicare Standardized Payment Amount | 9220.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 211 |
| Number Of Medical Services | 4733 |
| Number Of Medicare Beneficiaries With Medical Services | 2757 |
| Total Medical Submitted Charge Amount | 2704115.83 |
| Total Medical Medicare Allowed Amount | 601713.14 |
| Total Medical Medicare Payment Amount | 472377.89 |
| Total Medical Medicare Standardized Payment Amount | 510919.33 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 577 |
| Number Of Beneficiaries Age 65 to 74 | 1166 |
| Number Of Beneficiaries Age 75 to 84 | 791 |
| Number Of Beneficiaries Age Greater 84 | 231 |
| Number Of Female Beneficiaries | 1936 |
| Number Of Male Beneficiaries | 829 |
| Number Of Non Hispanic White Beneficiaries | 2622 |
| Number Of Black or African American Beneficiaries | 107 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2035 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 730 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3387 |