| National Provider Identifier [NPI]: | 1043591597 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | MARCIA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 525 W MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MOUNT PLEASANT |
| Zip Code Of The Provider | 156661833 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 187 |
| Number Of Medicare Beneficiaries | 31 |
| Total Submitted Charge Amount | 28714 |
| Total Medicare Allowed Amount | 12413.02 |
| Total Medicare Payment Amount | 9562.32 |
| Total Medicare Standardized Payment Amount | 9927.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 18 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 818 |
| Total Drug Medicare AllowedAmount | 279.73 |
| Total Drug Medicare PaymentAmount | 272.48 |
| Total Drug Medicare Standardized Payment Amount | 272.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 169 |
| Number Of Medicare Beneficiaries With Medical Services | 31 |
| Total Medical Submitted Charge Amount | 27896 |
| Total Medical Medicare Allowed Amount | 12133.29 |
| Total Medical Medicare Payment Amount | 9289.84 |
| Total Medical Medicare Standardized Payment Amount | 9654.53 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | 11 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0373 |