| National Provider Identifier [NPI]: | 1043221351 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1100 W CENTRAL RD |
| Street Address 2 Of The Provider | SUITE 205 |
| City Of The Provider | ARLINGTON HEIGHTS |
| Zip Code Of The Provider | 600052402 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 7760 |
| Number Of Medicare Beneficiaries | 2863 |
| Total Submitted Charge Amount | 3302620.48 |
| Total Medicare Allowed Amount | 1263701.04 |
| Total Medicare Payment Amount | 929304.64 |
| Total Medicare Standardized Payment Amount | 857427.79 |
| 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 | 43 |
| Number Of Medical Services | 7760 |
| Number Of Medicare Beneficiaries With Medical Services | 2863 |
| Total Medical Submitted Charge Amount | 3302620.48 |
| Total Medical Medicare Allowed Amount | 1263701.04 |
| Total Medical Medicare Payment Amount | 929304.64 |
| Total Medical Medicare Standardized Payment Amount | 857427.79 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 1047 |
| Number Of Beneficiaries Age 75 to 84 | 1182 |
| Number Of Beneficiaries Age Greater 84 | 577 |
| Number Of Female Beneficiaries | 1817 |
| Number Of Male Beneficiaries | 1046 |
| Number Of Non Hispanic White Beneficiaries | 2597 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | 110 |
| Number Of Hispanic Beneficiaries | 87 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2731 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 132 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0711 |