| National Provider Identifier [NPI]: | 1194796102 |
| Last Name Of The Provider | NELSEN |
| First Name Of The Provider | KRISTIN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3400 N CENTER RD |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | SAGINAW |
| Zip Code Of The Provider | 486037920 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 230 |
| Number Of Services | 9687 |
| Number Of Medicare Beneficiaries | 5511 |
| Total Submitted Charge Amount | 538224 |
| Total Medicare Allowed Amount | 277853.15 |
| Total Medicare Payment Amount | 210088.26 |
| Total Medicare Standardized Payment Amount | 217896.32 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 1221 |
| Number Of Beneficiaries Age 65 to 74 | 1847 |
| Number Of Beneficiaries Age 75 to 84 | 1556 |
| Number Of Beneficiaries Age Greater 84 | 887 |
| Number Of Female Beneficiaries | 3207 |
| Number Of Male Beneficiaries | 2304 |
| Number Of Non Hispanic White Beneficiaries | 4355 |
| Number Of Black or African American Beneficiaries | 877 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 210 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 47 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3925 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1586 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8958 |