| National Provider Identifier [NPI]: | 1760490809 |
| Last Name Of The Provider | MOL-PELTON |
| First Name Of The Provider | MELISSA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 BIRNIE AVE |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 011071107 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 1794 |
| Number Of Medicare Beneficiaries | 269 |
| Total Submitted Charge Amount | 195719 |
| Total Medicare Allowed Amount | 42108.98 |
| Total Medicare Payment Amount | 32856.55 |
| Total Medicare Standardized Payment Amount | 35619.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1124 |
| Number Of Medicare Beneficiaries With Drug Services | 119 |
| Total Drug Submitted ChargeAmount | 19584 |
| Total Drug Medicare AllowedAmount | 6323.44 |
| Total Drug Medicare PaymentAmount | 4957.83 |
| Total Drug Medicare Standardized Payment Amount | 4957.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 670 |
| Number Of Medicare Beneficiaries With Medical Services | 269 |
| Total Medical Submitted Charge Amount | 176135 |
| Total Medical Medicare Allowed Amount | 35785.54 |
| Total Medical Medicare Payment Amount | 27898.72 |
| Total Medical Medicare Standardized Payment Amount | 30661.9 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 68 |
| Number Of Beneficiaries Age 65 to 74 | 116 |
| Number Of Beneficiaries Age 75 to 84 | 62 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 165 |
| Number Of Male Beneficiaries | 104 |
| Number Of Non Hispanic White Beneficiaries | 204 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 173 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 96 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2111 |