| National Provider Identifier [NPI]: | 1407930621 |
| Last Name Of The Provider | NELSON |
| First Name Of The Provider | MALCOLM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 809 UNIVERSITY BLVD E |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUSCALOOSA |
| Zip Code Of The Provider | 354012029 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 556 |
| Number Of Medicare Beneficiaries | 171 |
| Total Submitted Charge Amount | 42362 |
| Total Medicare Allowed Amount | 28950.55 |
| Total Medicare Payment Amount | 18925.3 |
| Total Medicare Standardized Payment Amount | 21054.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 251 |
| Number Of Medicare Beneficiaries With Drug Services | 95 |
| Total Drug Submitted ChargeAmount | 1613 |
| Total Drug Medicare AllowedAmount | 1181.15 |
| Total Drug Medicare PaymentAmount | 816.75 |
| Total Drug Medicare Standardized Payment Amount | 816.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 305 |
| Number Of Medicare Beneficiaries With Medical Services | 171 |
| Total Medical Submitted Charge Amount | 40749 |
| Total Medical Medicare Allowed Amount | 27769.4 |
| Total Medical Medicare Payment Amount | 18108.55 |
| Total Medical Medicare Standardized Payment Amount | 20237.3 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 78 |
| Number Of Beneficiaries Age 75 to 84 | 48 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 107 |
| Number Of Male Beneficiaries | 64 |
| 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 | 159 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8706 |