National Provider Identifier [NPI]: |
1295061216 |
Last Name Of The Provider |
NELSON |
First Name Of The Provider |
SCOTT |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
800 E 28TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MINNEAPOLIS |
Zip Code Of The Provider |
554073723 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
631 |
Number Of Medicare Beneficiaries |
237 |
Total Submitted Charge Amount |
176040 |
Total Medicare Allowed Amount |
60284.76 |
Total Medicare Payment Amount |
46543.31 |
Total Medicare Standardized Payment Amount |
47934.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
15 |
Number Of Medical Services |
631 |
Number Of Medicare Beneficiaries With Medical Services |
237 |
Total Medical Submitted Charge Amount |
176040 |
Total Medical Medicare Allowed Amount |
60284.76 |
Total Medical Medicare Payment Amount |
46543.31 |
Total Medical Medicare Standardized Payment Amount |
47934.21 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
97 |
Number Of Beneficiaries Age 65 to 74 |
49 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
145 |
Number Of Male Beneficiaries |
92 |
Number Of Non Hispanic White Beneficiaries |
200 |
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 |
126 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
111 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
55 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
23 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.1798 |