Active NPI 1922250364 Individual Practitioner Female Practitioner

Melissa Sample , FNP

Nurse Practitioner - Family • Chiloquin, OR

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Melissa Sample, FNP is a certified Nurse Practitioner - Family practicing in Chiloquin, OR. With approximately 18 years of clinical experience since completing medical education in 2008, Melissa Sample delivers high-quality medical care to the local community at 103 WASO.

Melissa Sample is affiliated with Icco Llc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, automated urinalysis test. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

103 Waso

Chiloquin, OR 97624

Telephone 5418802011

Fax 5417833273

Associated Practice Facility / Clinic

🏢 Klamath Health Partnership, Inc. Facility NPI 1831501436

Medicare Profile & Education

Medical School

Other

Graduation Year

2008

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Family in Chiloquin, OR

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

18 Yrs +7.0 yrs vs City Avg

City Avg: 11.0 Yrs

State Avg: 11.2 Yrs

Regional Practice Density

4 Specialists

Practicing in Chiloquin, OR (2410 Statewide)

Telehealth Adoption Rate

25.0% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

71.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Sample (18 Years) 18 Yrs

Chiloquin Specialty Average (11.0 Years) 11.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	63	59	$374.13	$99.99
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	48	48	$485.79	$134.41
81003 Automated urinalysis test	31	29	$15.58	$1.44
0241U Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected	26	26	$427.00	$134.40
81002 Urinalysis, manual test	19	19	$15.79	$2.51
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	14	11	$41.79	$11.04

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81003 Automated urinalysis test	39	37	$21.10	$2.14
99213 Established patient office or other outpatient visit, typically 15 minutes	38	36	$264.39	$72.42
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	20	20	$324.99	$91.08
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	19	17	$374.13	$100.72
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	17	17	$96.98	$34.62
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$485.79	$135.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	91	84	$259.61	$73.74
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	84	84	$322.31	$91.34
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	67	63	$369.49	$105.04
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	63	61	$96.98	$34.96
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	36	18	$42.70	$11.76
81003 Automated urinalysis test	34	32	$21.00	$2.22
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	31	31	$480.89	$136.29
71046 X-ray of chest, 2 views	18	18	$96.50	$27.46
81002 Urinalysis, manual test	13	13	$20.00	$3.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	139	14	$45.43	$11.81
99213 Established patient office or other outpatient visit, typically 15 minutes	128	102	$202.21	$75.42
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	97	69	$296.34	$108.31
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	84	84	$294.39	$93.32
87426 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus	62	62	$96.98	$35.33
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	46	46	$447.84	$139.64
81003 Automated urinalysis test	43	39	$21.00	$2.20
80053 Blood test, comprehensive group of blood chemicals	28	26	$26.40	$10.56
36415 Insertion of needle into vein for collection of blood sample	24	23	$20.00	$2.88
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	20	20	$19.42	$7.38
71046 X-ray of chest, 2 views	20	19	$85.66	$27.87
81002 Urinalysis, manual test	13	13	$20.00	$3.48

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	293	241	$127.87	$62.31
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	149	114	$222.43	$90.01
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	129	24	$7.06	$1.41
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	109	38	$38.36	$11.89
81003 Automated urinalysis test	109	93	$11.88	$2.24
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	91	91	$256.94	$90.38
J1885 Injection, ketorolac tromethamine, per 15 mg	80	13	$7.43	$0.58
99202 New patient office or other outpatient visit, typically 20 minutes	79	79	$98.53	$62.81
36415 Insertion of needle into vein for collection of blood sample	74	65	$6.54	$2.90
80053 Blood test, comprehensive group of blood chemicals	66	61	$17.42	$10.45
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	62	59	$12.21	$7.59
71046 X-ray of chest, 2 views	60	57	$53.92	$26.84
J0696 Injection, ceftriaxone sodium, per 250 mg	50	11	$7.95	$0.56
90662 Influenza vaccine split virus, preservative free	18	18	$115.00	$58.55
93000 Routine ekg using at least 12 leads including interpretation and report	17	16	$30.52	$14.19
G0008 Administration of influenza virus vaccine	17	17	$63.00	$16.52
69210 Removal of impacted ear wax	16	16	$46.77	$38.56
72100 X-ray of lower and sacral spine, 2-3 views	15	15	$75.78	$30.12
90471 Administration of 1 vaccine	15	15	$28.62	$11.89
99284 Emergency department visit with moderate level of medical decision making	15	15	$253.50	$100.78
90714 Vaccine for tetanus and diphtheria toxoids injection into muscle, patient 7 years or older	15	15	$42.33	$25.38
87804 Detection test by immunoassay with direct visual observation for influenza virus	14	14	$16.55	$16.22
85379 Coagulation function measurement, d-dimer; quantitative	12	12	$15.27	$10.10
20610 Aspiration and/or injection of fluid from large joint	12	12	$86.69	$51.83
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	11	11	$122.54	$38.13
80061 Blood test, lipids (cholesterol and triglycerides)	11	11	$18.87	$13.24
10060 Simple or single drainage of skin abscess	11	11	$230.78	$101.46

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	461	341	$74.27	$60.14
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	140	26	$1.65	$1.60
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	139	127	$107.76	$88.26
99202 New patient office or other outpatient visit, typically 20 minutes	137	137	$76.11	$62.07
81003 Automated urinalysis test	130	106	$2.49	$2.44
36415 Insertion of needle into vein for collection of blood sample	115	103	$2.98	$2.88
80053 Blood test, comprehensive group of blood chemicals	91	85	$11.74	$11.51
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	79	74	$8.63	$8.46
71046 X-ray of chest, 2 views	74	70	$31.15	$25.47
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	51	44	$17.12	$13.49
J0696 Injection, ceftriaxone sodium, per 250 mg	48	13	$0.62	$0.58
J1885 Injection, ketorolac tromethamine, per 15 mg	44	11	$1.58	$0.46
69210 Removal of impacted ear wax	39	37	$46.96	$37.53
99284 Emergency department visit with moderate level of medical decision making	34	33	$249.00	$98.19
99283 Emergency department visit with low level of medical decision making	26	26	$131.25	$51.82
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	24	24	$110.66	$86.03
93000 Routine ekg using at least 12 leads including interpretation and report	21	21	$16.80	$13.89
20610 Aspiration and/or injection of fluid from large joint	17	15	$59.74	$48.96
83037 Hemoglobin a1c level, by device for home use	15	14	$11.99	$10.57
90714 Vaccine for tetanus and diphtheria toxoids injection into muscle, patient 7 years or older	15	15	$23.28	$23.00
90471 Administration of 1 vaccine	15	15	$16.52	$13.46
74018 X-ray of abdomen, 1 view	15	15	$27.96	$22.94
73630 X-ray of foot, minimum of 3 views	14	13	$30.74	$25.16
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	13	13	$16.53	$16.20
99282 Emergency department visit with straightforward medical decision making	13	13	$87.75	$34.58
87804 Detection test by immunoassay with direct visual observation for influenza virus	12	12	$16.55	$16.22
80061 Blood test, lipids (cholesterol and triglycerides)	12	12	$14.88	$14.58
73560 X-ray of knee, 1-2 views	12	12	$33.52	$25.04
10060 Simple or single drainage of skin abscess	12	12	$118.03	$96.24

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	485	368	$72.68	$59.22
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	204	36	$1.84	$1.81
36415 Insertion of needle into vein for collection of blood sample	154	133	$2.99	$2.92
99202 New patient office or other outpatient visit, typically 20 minutes	149	149	$74.57	$60.97
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	148	134	$107.56	$87.50
81003 Automated urinalysis test	112	92	$2.77	$2.71
80053 Blood test, comprehensive group of blood chemicals	102	95	$13.04	$12.78
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	100	91	$9.57	$9.38
71046 X-ray of chest, 2 views	89	84	$30.19	$24.62
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	82	61	$20.90	$16.57
J1885 Injection, ketorolac tromethamine, per 15 mg	69	17	$1.73	$0.55
J0696 Injection, ceftriaxone sodium, per 250 mg	65	18	$1.63	$0.63
69210 Removal of impacted ear wax	30	29	$48.10	$39.56
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	30	30	$106.41	$87.68
99284 Emergency department visit with moderate level of medical decision making	20	20	$249.00	$98.08
90471 Administration of 1 vaccine	18	18	$20.27	$16.55
90714 Vaccine for tetanus and diphtheria toxoids injection into muscle, patient 7 years or older	18	18	$24.05	$23.52
99283 Emergency department visit with low level of medical decision making	17	17	$131.25	$51.62
80061 Blood test, lipids (cholesterol and triglycerides)	17	16	$16.53	$16.20
20610 Aspiration and/or injection of fluid from large joint	15	12	$59.76	$49.05
83037 Hemoglobin a1c level, by device for home use	15	14	$11.99	$11.75
73030 X-ray of shoulder, minimum of 2 views	15	15	$28.92	$23.70
87804 Detection test by immunoassay with direct visual observation for influenza virus	15	15	$16.27	$15.30
72100 X-ray of lower and sacral spine, 2-3 views	13	13	$34.52	$28.23
73630 X-ray of foot, minimum of 3 views	12	11	$28.91	$23.70
73130 X-ray of hand, minimum of 3 views	12	12	$31.34	$25.75
93000 Routine ekg using at least 12 leads including interpretation and report	12	12	$17.90	$13.64
71100 X-ray of ribs of one side of body, 2 views	11	11	$32.78	$26.83

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	497	363	$72.94	$59.17
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	162	152	$106.64	$87.38
36415 Insertion of needle into vein for collection of blood sample	146	128	$3.05	$2.91
99202 New patient office or other outpatient visit, typically 20 minutes	137	137	$73.69	$60.72
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	121	23	$1.83	$1.79
81003 Automated urinalysis test	104	90	$3.06	$3.00
80053 Blood test, comprehensive group of blood chemicals	98	91	$14.49	$13.76
71020 X-ray of chest, 2 views, front and side	91	84	$27.52	$22.64
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	84	80	$10.66	$10.45
J0696 Injection, ceftriaxone sodium, per 250 mg	52	14	$0.70	$0.61
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	49	41	$25.11	$20.61
J1885 Injection, ketorolac tromethamine, per 15 mg	48	11	$0.53	$0.52
93000 Routine ekg using at least 12 leads including interpretation and report	36	33	$16.70	$13.76
69210 Removal of impacted ear wax	27	26	$50.25	$39.80
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$106.34	$87.59
83037 Hemoglobin a1c level, by device for home use	20	18	$13.39	$12.59
72100 X-ray of lower and sacral spine, 2-3 views	18	18	$34.46	$28.28
90714 Vaccine for tetanus and diphtheria toxoids injection into muscle, patient 7 years or older	17	17	$23.03	$22.24
90471 Administration of 1 vaccine	17	17	$25.11	$20.65
80061 Blood test, lipids (cholesterol and triglycerides)	16	16	$18.37	$14.58
87804 Detection test by immunoassay with direct visual observation for influenza virus	14	14	$16.44	$16.11
74000 X-ray of abdomen, single view	13	13	$23.31	$19.15
20610 Aspiration and/or injection of fluid from large joint	12	12	$62.63	$47.08
73630 X-ray of foot, minimum of 3 views	11	11	$30.43	$23.51
10060 Simple or single drainage of skin abscess	11	11	$115.98	$95.24

Medical Specialties & State Licenses

Nurse Practitioner - Family Primary Specialty

NUCC Taxonomy Code: 363LF0000X

State License OR 200850150NP

Definition to come...

Registered Nurse

NUCC Taxonomy Code: 163W00000X

State License OR 099000635RN

(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.

Hospital & Practice Group Affiliations

Icco Llc

2710 Willamette St, Eugene, OR 974053238

Phone: 5417353161

Icco Llc

2902 Tom Tennant Dr, Woodburn, OR 970712828

Phone: 5416407625

Icco Llc

598 E 13th Ave, Eugene, OR 974014783

Phone: 5416363473

Icco Llc

2920 Commercial St Se, Salem, OR 973024552

Phone: 9713014919

Icco Llc

3737 Shasta Way, Klamath Falls, OR 976034982

Phone: 5416407625

Icco Llc

1755 Sw Baker St, Mcminnville, OR 971289112

Phone: 9719004522

Icco Llc

355 W 3rd Ave, Junction City, OR 974481313

Phone: 5419986750

Icco Llc

4040 W 11th Ave, Eugene, OR 974025601

Phone: 5415002500

Icco Llc

186 W Ellendale Ave, Dallas, OR 973381408

Phone: 5416407625

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners

Marcy Ayres , RD

Dietitian, Registered

NPI 1114296720

Registered Dietitian

Dr. Qiang Yin , MD

Family Medicine

NPI 1225260946

Doctor of Medicine (M.D.)

Dr. Jamie Rich , MD

Internal Medicine

NPI 1295728624

Doctor of Medicine (M.D.)

Shadd Cunningham

Counselor

NPI 1508306259

Elizabeth Matuk , FNP

Nurse Practitioner - Family

NPI 1538156351

Family Nurse Practitioner

Dr. Tanya Mcdonald , DMD

Dentist

NPI 1619460680

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active January 15, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location January 15, 2015

Registered at 103 WASO, CHILOQUIN, OR 97624 (Tel: 5418802011)

📍

Updated Business Mailing Address January 15, 2015

Registered at 2074 S 6TH ST, KLAMATH FALLS, OR 976013372 (Tel: 5418802011)

👤

Provider Name / Credentials Updated January 15, 2015

Recorded as MELISSA SAMPLE, FNP

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 15, 2015

Registered Nurse (License #099000635RN in OR)

🟢

Initial NPI Registration & Enumeration October 16, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1922250364

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 16, 2008

Last Update: January 15, 2015

Sole Proprietor: No

Update or Correct Profile

Mailing Address

2074 S 6th St

Klamath Falls, OR 976013372

Phone: 5418802011

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.