| National Provider Identifier [NPI]: | 1609803774 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | PERRY |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 181 DANIEL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FOREST CITY |
| Zip Code Of The Provider | 280437151 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 1617 |
| Number Of Medicare Beneficiaries | 528 |
| Total Submitted Charge Amount | 269768 |
| Total Medicare Allowed Amount | 102121.4 |
| Total Medicare Payment Amount | 79525.1 |
| Total Medicare Standardized Payment Amount | 82642.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 100 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 8289 |
| Total Drug Medicare AllowedAmount | 2311.11 |
| Total Drug Medicare PaymentAmount | 2094.8 |
| Total Drug Medicare Standardized Payment Amount | 2094.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 1517 |
| Number Of Medicare Beneficiaries With Medical Services | 528 |
| Total Medical Submitted Charge Amount | 261479 |
| Total Medical Medicare Allowed Amount | 99810.29 |
| Total Medical Medicare Payment Amount | 77430.3 |
| Total Medical Medicare Standardized Payment Amount | 80548.1 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 178 |
| Number Of Beneficiaries Age 65 to 74 | 144 |
| Number Of Beneficiaries Age 75 to 84 | 128 |
| Number Of Beneficiaries Age Greater 84 | 78 |
| Number Of Female Beneficiaries | 292 |
| Number Of Male Beneficiaries | 236 |
| Number Of Non Hispanic White Beneficiaries | 447 |
| 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 | 282 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 246 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9082 |