| National Provider Identifier [NPI]: | 1134147358 |
| Last Name Of The Provider | NIELSON |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1563 E DOROTHY LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | KETTERING |
| Zip Code Of The Provider | 454293897 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 194 |
| Number Of Services | 8611 |
| Number Of Medicare Beneficiaries | 5518 |
| Total Submitted Charge Amount | 932074 |
| Total Medicare Allowed Amount | 243483.92 |
| Total Medicare Payment Amount | 183267.04 |
| Total Medicare Standardized Payment Amount | 187364.27 |
| 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 | 194 |
| Number Of Medical Services | 8611 |
| Number Of Medicare Beneficiaries With Medical Services | 5518 |
| Total Medical Submitted Charge Amount | 932074 |
| Total Medical Medicare Allowed Amount | 243483.92 |
| Total Medical Medicare Payment Amount | 183267.04 |
| Total Medical Medicare Standardized Payment Amount | 187364.27 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 1078 |
| Number Of Beneficiaries Age 65 to 74 | 1961 |
| Number Of Beneficiaries Age 75 to 84 | 1556 |
| Number Of Beneficiaries Age Greater 84 | 923 |
| Number Of Female Beneficiaries | 3274 |
| Number Of Male Beneficiaries | 2244 |
| Number Of Non Hispanic White Beneficiaries | 5022 |
| Number Of Black or African American Beneficiaries | 337 |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 78 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4165 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1353 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7334 |