| National Provider Identifier [NPI]: | 1407837560 |
| Last Name Of The Provider | MELLING |
| First Name Of The Provider | CARL |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1555 NORTHWAY DRIVE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | ST CLOUD |
| Zip Code Of The Provider | 563034913 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 1027 |
| Number Of Medicare Beneficiaries | 261 |
| Total Submitted Charge Amount | 126775.2 |
| Total Medicare Allowed Amount | 53540.05 |
| Total Medicare Payment Amount | 41952.5 |
| Total Medicare Standardized Payment Amount | 42690.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 60 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 1868.75 |
| Total Drug Medicare AllowedAmount | 1223.9 |
| Total Drug Medicare PaymentAmount | 1191.36 |
| Total Drug Medicare Standardized Payment Amount | 1191.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 967 |
| Number Of Medicare Beneficiaries With Medical Services | 261 |
| Total Medical Submitted Charge Amount | 124906.45 |
| Total Medical Medicare Allowed Amount | 52316.15 |
| Total Medical Medicare Payment Amount | 40761.14 |
| Total Medical Medicare Standardized Payment Amount | 41499.28 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 169 |
| Number Of Beneficiaries Age 65 to 74 | 40 |
| Number Of Beneficiaries Age 75 to 84 | 32 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 133 |
| Number Of Male Beneficiaries | 128 |
| Number Of Non Hispanic White Beneficiaries | 214 |
| Number Of Black or African American Beneficiaries | 32 |
| 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 | 78 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 183 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.7797 |