| National Provider Identifier [NPI]: | 1629002621 |
| Last Name Of The Provider | MELLMAN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 734 N. 3RD STREET SUITE 115 |
| Street Address 2 Of The Provider | |
| City Of The Provider | LEESBURG |
| Zip Code Of The Provider | 34748 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 208 |
| Number Of Services | 22981 |
| Number Of Medicare Beneficiaries | 4650 |
| Total Submitted Charge Amount | 1722324.07 |
| Total Medicare Allowed Amount | 521191.66 |
| Total Medicare Payment Amount | 389785.53 |
| Total Medicare Standardized Payment Amount | 421862.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 14916 |
| Number Of Medicare Beneficiaries With Drug Services | 249 |
| Total Drug Submitted ChargeAmount | 27138 |
| Total Drug Medicare AllowedAmount | 4121.3 |
| Total Drug Medicare PaymentAmount | 3194.22 |
| Total Drug Medicare Standardized Payment Amount | 3194.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 202 |
| Number Of Medical Services | 8065 |
| Number Of Medicare Beneficiaries With Medical Services | 4650 |
| Total Medical Submitted Charge Amount | 1695186.07 |
| Total Medical Medicare Allowed Amount | 517070.36 |
| Total Medical Medicare Payment Amount | 386591.31 |
| Total Medical Medicare Standardized Payment Amount | 418667.79 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 836 |
| Number Of Beneficiaries Age 65 to 74 | 1481 |
| Number Of Beneficiaries Age 75 to 84 | 1366 |
| Number Of Beneficiaries Age Greater 84 | 967 |
| Number Of Female Beneficiaries | 2765 |
| Number Of Male Beneficiaries | 1885 |
| Number Of Non Hispanic White Beneficiaries | 4290 |
| Number Of Black or African American Beneficiaries | 170 |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | 64 |
| Number Of American Indian Alaska Native Beneficiaries | 21 |
| Number Of Beneficiaries With Race Not Else where Classified | 63 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3534 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1116 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6952 |