| National Provider Identifier [NPI]: | 1194704262 |
| Last Name Of The Provider | MELLOTT |
| First Name Of The Provider | ANN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4110 BRIARGATE PKWY |
| Street Address 2 Of The Provider | SUITE 465 |
| City Of The Provider | COLORADO SPRINGS |
| Zip Code Of The Provider | 809207835 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 135 |
| Number Of Services | 97042 |
| Number Of Medicare Beneficiaries | 751 |
| Total Submitted Charge Amount | 7051659 |
| Total Medicare Allowed Amount | 1708189.13 |
| Total Medicare Payment Amount | 1339323.71 |
| Total Medicare Standardized Payment Amount | 1324391.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 67 |
| Number Of Drug Services | 86273 |
| Number Of Medicare Beneficiaries With Drug Services | 176 |
| Total Drug Submitted ChargeAmount | 5313410 |
| Total Drug Medicare AllowedAmount | 1314239.91 |
| Total Drug Medicare PaymentAmount | 1029987.79 |
| Total Drug Medicare Standardized Payment Amount | 1029987.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 10769 |
| Number Of Medicare Beneficiaries With Medical Services | 751 |
| Total Medical Submitted Charge Amount | 1738249 |
| Total Medical Medicare Allowed Amount | 393949.22 |
| Total Medical Medicare Payment Amount | 309335.92 |
| Total Medical Medicare Standardized Payment Amount | 294403.34 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 350 |
| Number Of Beneficiaries Age 75 to 84 | 248 |
| Number Of Beneficiaries Age Greater 84 | 97 |
| Number Of Female Beneficiaries | 485 |
| Number Of Male Beneficiaries | 266 |
| Number Of Non Hispanic White Beneficiaries | 556 |
| Number Of Black or African American Beneficiaries | 128 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 679 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 72 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 54 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.6238 |