| National Provider Identifier [NPI]: | 1841250149 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | CRAIG |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6296 E GRANT RD |
| Street Address 2 Of The Provider | STE 180 |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 857125833 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 6934 |
| Number Of Medicare Beneficiaries | 1176 |
| Total Submitted Charge Amount | 414366 |
| Total Medicare Allowed Amount | 323335.87 |
| Total Medicare Payment Amount | 221056.34 |
| Total Medicare Standardized Payment Amount | 218208.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 32 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 7917 |
| Total Drug Medicare AllowedAmount | 7655.87 |
| Total Drug Medicare PaymentAmount | 5642.12 |
| Total Drug Medicare Standardized Payment Amount | 5642.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 6902 |
| Number Of Medicare Beneficiaries With Medical Services | 1176 |
| Total Medical Submitted Charge Amount | 406449 |
| Total Medical Medicare Allowed Amount | 315680 |
| Total Medical Medicare Payment Amount | 215414.22 |
| Total Medical Medicare Standardized Payment Amount | 212566.31 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 474 |
| Number Of Beneficiaries Age 75 to 84 | 464 |
| Number Of Beneficiaries Age Greater 84 | 223 |
| Number Of Female Beneficiaries | 481 |
| Number Of Male Beneficiaries | 695 |
| Number Of Non Hispanic White Beneficiaries | 1145 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| 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 | 12 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9194 |