National Provider Identifier [NPI]: |
1225015670 |
Last Name Of The Provider |
NELSON |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
411 10TH ST SE |
Street Address 2 Of The Provider |
STE 1400 |
City Of The Provider |
CEDAR RAPIDS |
Zip Code Of The Provider |
524032467 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
83 |
Number Of Services |
5220 |
Number Of Medicare Beneficiaries |
710 |
Total Submitted Charge Amount |
685696.5 |
Total Medicare Allowed Amount |
369124.24 |
Total Medicare Payment Amount |
277987.29 |
Total Medicare Standardized Payment Amount |
296598.17 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
413 |
Number Of Medicare Beneficiaries With Drug Services |
186 |
Total Drug Submitted ChargeAmount |
15277.5 |
Total Drug Medicare AllowedAmount |
14204.77 |
Total Drug Medicare PaymentAmount |
13825.33 |
Total Drug Medicare Standardized Payment Amount |
13825.33 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
75 |
Number Of Medical Services |
4807 |
Number Of Medicare Beneficiaries With Medical Services |
710 |
Total Medical Submitted Charge Amount |
670419 |
Total Medical Medicare Allowed Amount |
354919.47 |
Total Medical Medicare Payment Amount |
264161.96 |
Total Medical Medicare Standardized Payment Amount |
282772.84 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
217 |
Number Of Beneficiaries Age 75 to 84 |
224 |
Number Of Beneficiaries Age Greater 84 |
230 |
Number Of Female Beneficiaries |
486 |
Number Of Male Beneficiaries |
224 |
Number Of Non Hispanic White Beneficiaries |
690 |
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 |
631 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
79 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.3927 |