National Provider Identifier [NPI]: |
1982687042 |
Last Name Of The Provider |
NELSON |
First Name Of The Provider |
SCOTT |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
612 W DUARTE RD |
Street Address 2 Of The Provider |
SUITE 404 |
City Of The Provider |
ARCADIA |
Zip Code Of The Provider |
910077602 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
466 |
Number Of Medicare Beneficiaries |
85 |
Total Submitted Charge Amount |
32839.5 |
Total Medicare Allowed Amount |
30764.99 |
Total Medicare Payment Amount |
22264.97 |
Total Medicare Standardized Payment Amount |
20841.69 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
55 |
Number Of Medicare Beneficiaries With Drug Services |
52 |
Total Drug Submitted ChargeAmount |
1521.5 |
Total Drug Medicare AllowedAmount |
760.73 |
Total Drug Medicare PaymentAmount |
745.48 |
Total Drug Medicare Standardized Payment Amount |
745.48 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
10 |
Number Of Medical Services |
411 |
Number Of Medicare Beneficiaries With Medical Services |
85 |
Total Medical Submitted Charge Amount |
31318 |
Total Medical Medicare Allowed Amount |
30004.26 |
Total Medical Medicare Payment Amount |
21519.49 |
Total Medical Medicare Standardized Payment Amount |
20096.21 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
44 |
Number Of Beneficiaries Age 75 to 84 |
24 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
33 |
Number Of Male Beneficiaries |
52 |
Number Of Non Hispanic White Beneficiaries |
60 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
|
Percent Of With Diabetes |
14 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8728 |