| National Provider Identifier [NPI]: | 1730171026 |
| Last Name Of The Provider | MELLITT |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1605 E BROADWAY |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | COLUMBIA |
| Zip Code Of The Provider | 652018023 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiac Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 518 |
| Number Of Medicare Beneficiaries | 219 |
| Total Submitted Charge Amount | 817700 |
| Total Medicare Allowed Amount | 355535.33 |
| Total Medicare Payment Amount | 277355.26 |
| Total Medicare Standardized Payment Amount | 289628.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 518 |
| Number Of Medicare Beneficiaries With Medical Services | 219 |
| Total Medical Submitted Charge Amount | 817700 |
| Total Medical Medicare Allowed Amount | 355535.33 |
| Total Medical Medicare Payment Amount | 277355.26 |
| Total Medical Medicare Standardized Payment Amount | 289628.51 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 77 |
| Number Of Beneficiaries Age 75 to 84 | 106 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 107 |
| Number Of Male Beneficiaries | 112 |
| 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 | 204 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 30 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2682 |