| National Provider Identifier [NPI]: | 1770583437 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | LISA |
| 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 | 2950 S MARYLAND PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891092204 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 120 |
| Number Of Services | 3345 |
| Number Of Medicare Beneficiaries | 2247 |
| Total Submitted Charge Amount | 388266.35 |
| Total Medicare Allowed Amount | 180073.22 |
| Total Medicare Payment Amount | 133131.52 |
| Total Medicare Standardized Payment Amount | 133274.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 195 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 380.35 |
| Total Drug Medicare AllowedAmount | 173.21 |
| Total Drug Medicare PaymentAmount | 135.8 |
| Total Drug Medicare Standardized Payment Amount | 135.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 116 |
| Number Of Medical Services | 3150 |
| Number Of Medicare Beneficiaries With Medical Services | 2247 |
| Total Medical Submitted Charge Amount | 387886 |
| Total Medical Medicare Allowed Amount | 179900.01 |
| Total Medical Medicare Payment Amount | 132995.72 |
| Total Medical Medicare Standardized Payment Amount | 133138.87 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 363 |
| Number Of Beneficiaries Age 65 to 74 | 1056 |
| Number Of Beneficiaries Age 75 to 84 | 636 |
| Number Of Beneficiaries Age Greater 84 | 192 |
| Number Of Female Beneficiaries | 1469 |
| Number Of Male Beneficiaries | 778 |
| Number Of Non Hispanic White Beneficiaries | 1324 |
| Number Of Black or African American Beneficiaries | 256 |
| Number Of AsianPacific Islander Beneficiaries | 185 |
| Number Of Hispanic Beneficiaries | 415 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1639 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 608 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2997 |