| National Provider Identifier [NPI]: | 1073557435 |
| Last Name Of The Provider | GENCHEFF |
| First Name Of The Provider | NELSON |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1414 WEST FAIR AVENUE |
| Street Address 2 Of The Provider | SUITE 334 |
| City Of The Provider | MARQUETTE |
| Zip Code Of The Provider | 49855 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 1829 |
| Number Of Medicare Beneficiaries | 703 |
| Total Submitted Charge Amount | 983225.46 |
| Total Medicare Allowed Amount | 176498.11 |
| Total Medicare Payment Amount | 132471.62 |
| Total Medicare Standardized Payment Amount | 136774.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 40 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 8000 |
| Total Drug Medicare AllowedAmount | 2240.28 |
| Total Drug Medicare PaymentAmount | 1756.45 |
| Total Drug Medicare Standardized Payment Amount | 1756.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 1789 |
| Number Of Medicare Beneficiaries With Medical Services | 703 |
| Total Medical Submitted Charge Amount | 975225.46 |
| Total Medical Medicare Allowed Amount | 174257.83 |
| Total Medical Medicare Payment Amount | 130715.17 |
| Total Medical Medicare Standardized Payment Amount | 135018.45 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 97 |
| Number Of Beneficiaries Age 65 to 74 | 287 |
| Number Of Beneficiaries Age 75 to 84 | 238 |
| Number Of Beneficiaries Age Greater 84 | 81 |
| Number Of Female Beneficiaries | 309 |
| Number Of Male Beneficiaries | 394 |
| Number Of Non Hispanic White Beneficiaries | 656 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 34 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 577 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 126 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4313 |