| National Provider Identifier [NPI]: | 1386878817 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3990 JOHN R ST |
| Street Address 2 Of The Provider | BOX 162, ROOM 2901 |
| City Of The Provider | DETROIT |
| Zip Code Of The Provider | 482012018 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 355 |
| Number Of Medicare Beneficiaries | 265 |
| Total Submitted Charge Amount | 444242 |
| Total Medicare Allowed Amount | 57224.94 |
| Total Medicare Payment Amount | 44703.05 |
| Total Medicare Standardized Payment Amount | 42437.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 43 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 1035 |
| Total Drug Medicare AllowedAmount | 10.94 |
| Total Drug Medicare PaymentAmount | 8.6 |
| Total Drug Medicare Standardized Payment Amount | 8.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 312 |
| Number Of Medicare Beneficiaries With Medical Services | 265 |
| Total Medical Submitted Charge Amount | 443207 |
| Total Medical Medicare Allowed Amount | 57214 |
| Total Medical Medicare Payment Amount | 44694.45 |
| Total Medical Medicare Standardized Payment Amount | 42429.37 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 112 |
| Number Of Beneficiaries Age 65 to 74 | 86 |
| Number Of Beneficiaries Age 75 to 84 | 50 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 142 |
| Number Of Male Beneficiaries | 123 |
| Number Of Non Hispanic White Beneficiaries | 64 |
| Number Of Black or African American Beneficiaries | 190 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 117 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 148 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 22 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 55 |
| Percent Of With Chronic Kidney Disease | 55 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.9305 |