National Provider Identifier [NPI]: |
1821026238 |
Last Name Of The Provider |
CHARLES |
First Name Of The Provider |
NELSON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1550 BARKLEY CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT MYERS |
Zip Code Of The Provider |
339074539 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
8161 |
Number Of Medicare Beneficiaries |
4179 |
Total Submitted Charge Amount |
1545830 |
Total Medicare Allowed Amount |
617588.84 |
Total Medicare Payment Amount |
451781.41 |
Total Medicare Standardized Payment Amount |
437324.48 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
54 |
Number Of Medicare Beneficiaries With Drug Services |
54 |
Total Drug Submitted ChargeAmount |
594 |
Total Drug Medicare AllowedAmount |
116.03 |
Total Drug Medicare PaymentAmount |
87.74 |
Total Drug Medicare Standardized Payment Amount |
87.74 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
44 |
Number Of Medical Services |
8107 |
Number Of Medicare Beneficiaries With Medical Services |
4178 |
Total Medical Submitted Charge Amount |
1545236 |
Total Medical Medicare Allowed Amount |
617472.81 |
Total Medical Medicare Payment Amount |
451693.67 |
Total Medical Medicare Standardized Payment Amount |
437236.74 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
245 |
Number Of Beneficiaries Age 65 to 74 |
1584 |
Number Of Beneficiaries Age 75 to 84 |
1646 |
Number Of Beneficiaries Age Greater 84 |
704 |
Number Of Female Beneficiaries |
1845 |
Number Of Male Beneficiaries |
2334 |
Number Of Non Hispanic White Beneficiaries |
3670 |
Number Of Black or African American Beneficiaries |
106 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
319 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
56 |
Number Of Beneficiaries With Medicare Only Entitlement |
3729 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
450 |
Percent Of With Atrial Fibrillation |
39 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.5107 |