| National Provider Identifier [NPI]: | 1972893139 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | MELANIE |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2103 FOREST DR |
| Street Address 2 Of The Provider | STE 5 |
| City Of The Provider | GRAY |
| Zip Code Of The Provider | 376158422 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 625 |
| Number Of Medicare Beneficiaries | 41 |
| Total Submitted Charge Amount | 68112 |
| Total Medicare Allowed Amount | 18884.07 |
| Total Medicare Payment Amount | 13798.98 |
| Total Medicare Standardized Payment Amount | 17522.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 150 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 1816 |
| Total Drug Medicare AllowedAmount | 460.48 |
| Total Drug Medicare PaymentAmount | 384.94 |
| Total Drug Medicare Standardized Payment Amount | 384.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 475 |
| Number Of Medicare Beneficiaries With Medical Services | 41 |
| Total Medical Submitted Charge Amount | 66296 |
| Total Medical Medicare Allowed Amount | 18423.59 |
| Total Medical Medicare Payment Amount | 13414.04 |
| Total Medical Medicare Standardized Payment Amount | 17137.94 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 18 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 27 |
| Number Of Male Beneficiaries | 14 |
| 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 | 24 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0285 |