| National Provider Identifier [NPI]: | 1124067111 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20 ELM ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PITTSFIELD |
| Zip Code Of The Provider | 012016502 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 691 |
| Number Of Medicare Beneficiaries | 264 |
| Total Submitted Charge Amount | 67300.51 |
| Total Medicare Allowed Amount | 55584.18 |
| Total Medicare Payment Amount | 38585.46 |
| Total Medicare Standardized Payment Amount | 37446.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 460.51 |
| Total Drug Medicare AllowedAmount | 412.72 |
| Total Drug Medicare PaymentAmount | 397.93 |
| Total Drug Medicare Standardized Payment Amount | 397.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 664 |
| Number Of Medicare Beneficiaries With Medical Services | 264 |
| Total Medical Submitted Charge Amount | 66840 |
| Total Medical Medicare Allowed Amount | 55171.46 |
| Total Medical Medicare Payment Amount | 38187.53 |
| Total Medical Medicare Standardized Payment Amount | 37048.36 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 91 |
| Number Of Beneficiaries Age 65 to 74 | 101 |
| Number Of Beneficiaries Age 75 to 84 | 50 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 193 |
| Number Of Male Beneficiaries | 71 |
| Number Of Non Hispanic White Beneficiaries | 252 |
| 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 | 151 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 113 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0012 |