| National Provider Identifier [NPI]: | 1124289442 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | NICOLE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 500 J. CLYDE MORRIS BLVD |
| Street Address 2 Of The Provider | DEPARTMENT OF EMERGENCY MEDICINE |
| City Of The Provider | NEWPORT NEWS |
| Zip Code Of The Provider | 23601 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 672 |
| Number Of Medicare Beneficiaries | 584 |
| Total Submitted Charge Amount | 332850 |
| Total Medicare Allowed Amount | 105686.42 |
| Total Medicare Payment Amount | 80420.89 |
| Total Medicare Standardized Payment Amount | 82236.17 |
| 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 | 24 |
| Number Of Medical Services | 672 |
| Number Of Medicare Beneficiaries With Medical Services | 584 |
| Total Medical Submitted Charge Amount | 332850 |
| Total Medical Medicare Allowed Amount | 105686.42 |
| Total Medical Medicare Payment Amount | 80420.89 |
| Total Medical Medicare Standardized Payment Amount | 82236.17 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 172 |
| Number Of Beneficiaries Age 65 to 74 | 170 |
| Number Of Beneficiaries Age 75 to 84 | 152 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 310 |
| Number Of Male Beneficiaries | 274 |
| Number Of Non Hispanic White Beneficiaries | 353 |
| Number Of Black or African American Beneficiaries | 214 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 418 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 166 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.1341 |