| National Provider Identifier [NPI]: | 1881673051 |
| Last Name Of The Provider | SALEHI |
| First Name Of The Provider | ALI |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12951 SOUTH FWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770471923 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 3513 |
| Number Of Medicare Beneficiaries | 722 |
| Total Submitted Charge Amount | 406754.19 |
| Total Medicare Allowed Amount | 113469.51 |
| Total Medicare Payment Amount | 92482.44 |
| Total Medicare Standardized Payment Amount | 92659.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2091 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 20844.84 |
| Total Drug Medicare AllowedAmount | 795.44 |
| Total Drug Medicare PaymentAmount | 623.62 |
| Total Drug Medicare Standardized Payment Amount | 623.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 93 |
| Number Of Medical Services | 1422 |
| Number Of Medicare Beneficiaries With Medical Services | 722 |
| Total Medical Submitted Charge Amount | 385909.35 |
| Total Medical Medicare Allowed Amount | 112674.07 |
| Total Medical Medicare Payment Amount | 91858.82 |
| Total Medical Medicare Standardized Payment Amount | 92035.72 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 105 |
| Number Of Beneficiaries Age 65 to 74 | 284 |
| Number Of Beneficiaries Age 75 to 84 | 222 |
| Number Of Beneficiaries Age Greater 84 | 111 |
| Number Of Female Beneficiaries | 538 |
| Number Of Male Beneficiaries | 184 |
| Number Of Non Hispanic White Beneficiaries | 267 |
| Number Of Black or African American Beneficiaries | 180 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 258 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 460 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 262 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3791 |