| National Provider Identifier [NPI]: | 1477543692 |
| Last Name Of The Provider | MELLA |
| First Name Of The Provider | RAMON |
| 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 | 3240 W FRANKLIN BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606241511 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 1045 |
| Number Of Medicare Beneficiaries | 186 |
| Total Submitted Charge Amount | 170416 |
| Total Medicare Allowed Amount | 96539.51 |
| Total Medicare Payment Amount | 68575.84 |
| Total Medicare Standardized Payment Amount | 64190.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 69 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 901 |
| Total Drug Medicare AllowedAmount | 524.14 |
| Total Drug Medicare PaymentAmount | 495.03 |
| Total Drug Medicare Standardized Payment Amount | 495.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 976 |
| Number Of Medicare Beneficiaries With Medical Services | 186 |
| Total Medical Submitted Charge Amount | 169515 |
| Total Medical Medicare Allowed Amount | 96015.37 |
| Total Medical Medicare Payment Amount | 68080.81 |
| Total Medical Medicare Standardized Payment Amount | 63695.59 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 61 |
| Number Of Beneficiaries Age 75 to 84 | 61 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 101 |
| Number Of Male Beneficiaries | 85 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 121 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 52 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 61 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 125 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 22 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 45 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.7093 |