| National Provider Identifier [NPI]: | 1194807651 |
| Last Name Of The Provider | CLARY |
| First Name Of The Provider | MELISSA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1709 EAST BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHARLOTTE |
| Zip Code Of The Provider | 282035823 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 719 |
| Number Of Medicare Beneficiaries | 195 |
| Total Submitted Charge Amount | 54867 |
| Total Medicare Allowed Amount | 19205.49 |
| Total Medicare Payment Amount | 11453.99 |
| Total Medicare Standardized Payment Amount | 16503.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 350 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 5475 |
| Total Drug Medicare AllowedAmount | 168.3 |
| Total Drug Medicare PaymentAmount | 117.03 |
| Total Drug Medicare Standardized Payment Amount | 117.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 369 |
| Number Of Medicare Beneficiaries With Medical Services | 195 |
| Total Medical Submitted Charge Amount | 49392 |
| Total Medical Medicare Allowed Amount | 19037.19 |
| Total Medical Medicare Payment Amount | 11336.96 |
| Total Medical Medicare Standardized Payment Amount | 16386.13 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 73 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 130 |
| Number Of Male Beneficiaries | 65 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 115 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 80 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0921 |