| National Provider Identifier [NPI]: | 1700855194 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | MICHAEL |
| 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 | 8901 W 74TH ST |
| Street Address 2 Of The Provider | SUITE 390 |
| City Of The Provider | SHAWNEE MISSION |
| Zip Code Of The Provider | 662042204 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 3355 |
| Number Of Medicare Beneficiaries | 980 |
| Total Submitted Charge Amount | 588705 |
| Total Medicare Allowed Amount | 269349.98 |
| Total Medicare Payment Amount | 200114.76 |
| Total Medicare Standardized Payment Amount | 214301.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 56 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 2202 |
| Total Drug Medicare AllowedAmount | 1639.92 |
| Total Drug Medicare PaymentAmount | 1607.1 |
| Total Drug Medicare Standardized Payment Amount | 1607.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 3299 |
| Number Of Medicare Beneficiaries With Medical Services | 980 |
| Total Medical Submitted Charge Amount | 586503 |
| Total Medical Medicare Allowed Amount | 267710.06 |
| Total Medical Medicare Payment Amount | 198507.66 |
| Total Medical Medicare Standardized Payment Amount | 212694.79 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 119 |
| Number Of Beneficiaries Age 65 to 74 | 380 |
| Number Of Beneficiaries Age 75 to 84 | 313 |
| Number Of Beneficiaries Age Greater 84 | 168 |
| Number Of Female Beneficiaries | 533 |
| Number Of Male Beneficiaries | 447 |
| Number Of Non Hispanic White Beneficiaries | 901 |
| Number Of Black or African American Beneficiaries | 35 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 872 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 108 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 51 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.8055 |