| National Provider Identifier [NPI]: | 1366565202 |
| Last Name Of The Provider | MELNICK |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | NURSE PRACTITIONER |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 883 E MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | RIVERHEAD |
| Zip Code Of The Provider | 119012613 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 2219 |
| Number Of Medicare Beneficiaries | 526 |
| Total Submitted Charge Amount | 387243.41 |
| Total Medicare Allowed Amount | 113273.22 |
| Total Medicare Payment Amount | 82276.97 |
| Total Medicare Standardized Payment Amount | 82873.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 183 |
| Number Of Medicare Beneficiaries With Drug Services | 168 |
| Total Drug Submitted ChargeAmount | 7884.01 |
| Total Drug Medicare AllowedAmount | 3627.26 |
| Total Drug Medicare PaymentAmount | 3553.51 |
| Total Drug Medicare Standardized Payment Amount | 3553.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 2036 |
| Number Of Medicare Beneficiaries With Medical Services | 526 |
| Total Medical Submitted Charge Amount | 379359.4 |
| Total Medical Medicare Allowed Amount | 109645.96 |
| Total Medical Medicare Payment Amount | 78723.46 |
| Total Medical Medicare Standardized Payment Amount | 79319.56 |
| Average Age Of Beneficiaries | 52 |
| Number Of Beneficiaries Age Less65 | 437 |
| Number Of Beneficiaries Age 65 to 74 | 65 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 231 |
| Number Of Male Beneficiaries | 295 |
| Number Of Non Hispanic White Beneficiaries | 415 |
| Number Of Black or African American Beneficiaries | 74 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| 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 | |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 3 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 37 |
| Percent Of With Ischemic Heart Disease | 11 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 11 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 26 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9974 |