| National Provider Identifier [NPI]: | 1255541843 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2535 MAPLECREST RD STE 10 |
| Street Address 2 Of The Provider | |
| City Of The Provider | BETTENDORF |
| Zip Code Of The Provider | 527222799 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Endocrinology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 2701 |
| Number Of Medicare Beneficiaries | 504 |
| Total Submitted Charge Amount | 250540 |
| Total Medicare Allowed Amount | 123385.2 |
| Total Medicare Payment Amount | 90462.13 |
| Total Medicare Standardized Payment Amount | 98219.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1091 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 42662 |
| Total Drug Medicare AllowedAmount | 35813.89 |
| Total Drug Medicare PaymentAmount | 27384.17 |
| Total Drug Medicare Standardized Payment Amount | 27384.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 1610 |
| Number Of Medicare Beneficiaries With Medical Services | 504 |
| Total Medical Submitted Charge Amount | 207878 |
| Total Medical Medicare Allowed Amount | 87571.31 |
| Total Medical Medicare Payment Amount | 63077.96 |
| Total Medical Medicare Standardized Payment Amount | 70835.71 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 86 |
| Number Of Beneficiaries Age 65 to 74 | 239 |
| Number Of Beneficiaries Age 75 to 84 | 140 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 372 |
| Number Of Male Beneficiaries | 132 |
| Number Of Non Hispanic White Beneficiaries | 477 |
| Number Of Black or African American Beneficiaries | |
| 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 | 429 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.145 |