| National Provider Identifier [NPI]: | 1780823104 |
| Last Name Of The Provider | MELTON |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | A.R.N.P. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 E CLARK BASS BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MCALESTER |
| Zip Code Of The Provider | 745014209 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 1007 |
| Number Of Medicare Beneficiaries | 316 |
| Total Submitted Charge Amount | 96561.44 |
| Total Medicare Allowed Amount | 29472.37 |
| Total Medicare Payment Amount | 20594.1 |
| Total Medicare Standardized Payment Amount | 26377.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 344 |
| Number Of Medicare Beneficiaries With Drug Services | 80 |
| Total Drug Submitted ChargeAmount | 1916.19 |
| Total Drug Medicare AllowedAmount | 499.31 |
| Total Drug Medicare PaymentAmount | 373.78 |
| Total Drug Medicare Standardized Payment Amount | 373.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 663 |
| Number Of Medicare Beneficiaries With Medical Services | 316 |
| Total Medical Submitted Charge Amount | 94645.25 |
| Total Medical Medicare Allowed Amount | 28973.06 |
| Total Medical Medicare Payment Amount | 20220.32 |
| Total Medical Medicare Standardized Payment Amount | 26004.12 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 93 |
| Number Of Beneficiaries Age 65 to 74 | 143 |
| Number Of Beneficiaries Age 75 to 84 | 58 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 192 |
| Number Of Male Beneficiaries | 124 |
| Number Of Non Hispanic White Beneficiaries | 171 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 131 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 218 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 98 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1258 |