| National Provider Identifier [NPI]: | 1427083450 |
| Last Name Of The Provider | MELLMAN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MEDICAL DOCTOR |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 390 N SEPULVEDA BLVD |
| Street Address 2 Of The Provider | SUITE 1065 |
| City Of The Provider | EL SEGUNDO |
| Zip Code Of The Provider | 902454475 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 2259 |
| Number Of Medicare Beneficiaries | 373 |
| Total Submitted Charge Amount | 336453 |
| Total Medicare Allowed Amount | 153907.55 |
| Total Medicare Payment Amount | 117101.01 |
| Total Medicare Standardized Payment Amount | 109790.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 101 |
| Number Of Medicare Beneficiaries With Drug Services | 96 |
| Total Drug Submitted ChargeAmount | 5835 |
| Total Drug Medicare AllowedAmount | 2294.31 |
| Total Drug Medicare PaymentAmount | 2202.37 |
| Total Drug Medicare Standardized Payment Amount | 2202.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 2158 |
| Number Of Medicare Beneficiaries With Medical Services | 372 |
| Total Medical Submitted Charge Amount | 330618 |
| Total Medical Medicare Allowed Amount | 151613.24 |
| Total Medical Medicare Payment Amount | 114898.64 |
| Total Medical Medicare Standardized Payment Amount | 107587.79 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 215 |
| Number Of Beneficiaries Age 75 to 84 | 106 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 163 |
| Number Of Male Beneficiaries | 210 |
| Number Of Non Hispanic White Beneficiaries | 313 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 64 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.8611 |