National Provider Identifier [NPI]: |
1932125630 |
Last Name Of The Provider |
NELSON |
First Name Of The Provider |
SHELDON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1233 N 30TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BILLINGS |
Zip Code Of The Provider |
591010127 |
State Code Of The Provider |
MT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
529 |
Number Of Medicare Beneficiaries |
464 |
Total Submitted Charge Amount |
206502.5 |
Total Medicare Allowed Amount |
67963.3 |
Total Medicare Payment Amount |
49755.12 |
Total Medicare Standardized Payment Amount |
49535.1 |
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 |
13 |
Number Of Medical Services |
529 |
Number Of Medicare Beneficiaries With Medical Services |
464 |
Total Medical Submitted Charge Amount |
206502.5 |
Total Medical Medicare Allowed Amount |
67963.3 |
Total Medical Medicare Payment Amount |
49755.12 |
Total Medical Medicare Standardized Payment Amount |
49535.1 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
150 |
Number Of Beneficiaries Age 65 to 74 |
137 |
Number Of Beneficiaries Age 75 to 84 |
104 |
Number Of Beneficiaries Age Greater 84 |
73 |
Number Of Female Beneficiaries |
246 |
Number Of Male Beneficiaries |
218 |
Number Of Non Hispanic White Beneficiaries |
371 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
64 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
309 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
155 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.5412 |