| National Provider Identifier [NPI]: | 1023078698 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | KRISTIN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1515 DELHI ST |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | DUBUQUE |
| Zip Code Of The Provider | 520016320 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 177 |
| Number Of Services | 10964 |
| Number Of Medicare Beneficiaries | 533 |
| Total Submitted Charge Amount | 820013.65 |
| Total Medicare Allowed Amount | 302295.62 |
| Total Medicare Payment Amount | 244256.4 |
| Total Medicare Standardized Payment Amount | 262780.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 3429 |
| Number Of Medicare Beneficiaries With Drug Services | 319 |
| Total Drug Submitted ChargeAmount | 61763.65 |
| Total Drug Medicare AllowedAmount | 33489.31 |
| Total Drug Medicare PaymentAmount | 28777.57 |
| Total Drug Medicare Standardized Payment Amount | 28777.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 160 |
| Number Of Medical Services | 7535 |
| Number Of Medicare Beneficiaries With Medical Services | 533 |
| Total Medical Submitted Charge Amount | 758250 |
| Total Medical Medicare Allowed Amount | 268806.31 |
| Total Medical Medicare Payment Amount | 215478.83 |
| Total Medical Medicare Standardized Payment Amount | 234002.84 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 288 |
| Number Of Beneficiaries Age 75 to 84 | 160 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 432 |
| Number Of Male Beneficiaries | 101 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 477 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 11 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 21 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.7502 |