| National Provider Identifier [NPI]: | 1992725907 |
| Last Name Of The Provider | MELLO |
| First Name Of The Provider | ANSEL |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1379 E HERNDON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FRESNO |
| Zip Code Of The Provider | 937203309 |
| 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 | 97 |
| Number Of Services | 5703 |
| Number Of Medicare Beneficiaries | 651 |
| Total Submitted Charge Amount | 682357.4 |
| Total Medicare Allowed Amount | 282657.74 |
| Total Medicare Payment Amount | 205931.27 |
| Total Medicare Standardized Payment Amount | 199482.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 650 |
| Number Of Medicare Beneficiaries With Drug Services | 270 |
| Total Drug Submitted ChargeAmount | 11869 |
| Total Drug Medicare AllowedAmount | 8335.73 |
| Total Drug Medicare PaymentAmount | 7897.01 |
| Total Drug Medicare Standardized Payment Amount | 7897.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 89 |
| Number Of Medical Services | 5053 |
| Number Of Medicare Beneficiaries With Medical Services | 651 |
| Total Medical Submitted Charge Amount | 670488.4 |
| Total Medical Medicare Allowed Amount | 274322.01 |
| Total Medical Medicare Payment Amount | 198034.26 |
| Total Medical Medicare Standardized Payment Amount | 191585.82 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 290 |
| Number Of Beneficiaries Age 75 to 84 | 225 |
| Number Of Beneficiaries Age Greater 84 | 124 |
| Number Of Female Beneficiaries | 341 |
| Number Of Male Beneficiaries | 310 |
| Number Of Non Hispanic White Beneficiaries | 584 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| 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 | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9328 |