| National Provider Identifier [NPI]: | 1770550030 |
| Last Name Of The Provider | NIELSEN |
| First Name Of The Provider | EARL |
| 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 | 21 PERRY STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | MORRISTOWN |
| Zip Code Of The Provider | 07960 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 923 |
| Number Of Medicare Beneficiaries | 255 |
| Total Submitted Charge Amount | 188813 |
| Total Medicare Allowed Amount | 97556.01 |
| Total Medicare Payment Amount | 72402.67 |
| Total Medicare Standardized Payment Amount | 67234.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 50 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 1910 |
| Total Drug Medicare AllowedAmount | 1022.38 |
| Total Drug Medicare PaymentAmount | 997.99 |
| Total Drug Medicare Standardized Payment Amount | 997.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 873 |
| Number Of Medicare Beneficiaries With Medical Services | 255 |
| Total Medical Submitted Charge Amount | 186903 |
| Total Medical Medicare Allowed Amount | 96533.63 |
| Total Medical Medicare Payment Amount | 71404.68 |
| Total Medical Medicare Standardized Payment Amount | 66236.99 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 107 |
| Number Of Beneficiaries Age 75 to 84 | 84 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 123 |
| Number Of Male Beneficiaries | 132 |
| Number Of Non Hispanic White Beneficiaries | 183 |
| Number Of Black or African American Beneficiaries | 40 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| 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 | 227 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.6271 |