| National Provider Identifier [NPI]: | 1639194913 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7001 FOREST AVE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 232301726 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 2655 |
| Number Of Medicare Beneficiaries | 1394 |
| Total Submitted Charge Amount | 414600 |
| Total Medicare Allowed Amount | 161127.68 |
| Total Medicare Payment Amount | 114321.99 |
| Total Medicare Standardized Payment Amount | 117464.63 |
| 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 | 37 |
| Number Of Medical Services | 2655 |
| Number Of Medicare Beneficiaries With Medical Services | 1394 |
| Total Medical Submitted Charge Amount | 414600 |
| Total Medical Medicare Allowed Amount | 161127.68 |
| Total Medical Medicare Payment Amount | 114321.99 |
| Total Medical Medicare Standardized Payment Amount | 117464.63 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 135 |
| Number Of Beneficiaries Age 65 to 74 | 527 |
| Number Of Beneficiaries Age 75 to 84 | 438 |
| Number Of Beneficiaries Age Greater 84 | 294 |
| Number Of Female Beneficiaries | 771 |
| Number Of Male Beneficiaries | 623 |
| Number Of Non Hispanic White Beneficiaries | 1093 |
| Number Of Black or African American Beneficiaries | 264 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1203 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 191 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.5767 |