| National Provider Identifier [NPI]: | 1306011416 |
| Last Name Of The Provider | SALEK |
| First Name Of The Provider | BRETT |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1540 LAKE ST S |
| Street Address 2 Of The Provider | |
| City Of The Provider | FOREST LAKE |
| Zip Code Of The Provider | 550252628 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 2396 |
| Number Of Medicare Beneficiaries | 281 |
| Total Submitted Charge Amount | 189242 |
| Total Medicare Allowed Amount | 81157.38 |
| Total Medicare Payment Amount | 56971.64 |
| Total Medicare Standardized Payment Amount | 58831.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 448 |
| Number Of Medicare Beneficiaries With Drug Services | 112 |
| Total Drug Submitted ChargeAmount | 11089 |
| Total Drug Medicare AllowedAmount | 4731.44 |
| Total Drug Medicare PaymentAmount | 3931.89 |
| Total Drug Medicare Standardized Payment Amount | 3931.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 1948 |
| Number Of Medicare Beneficiaries With Medical Services | 281 |
| Total Medical Submitted Charge Amount | 178153 |
| Total Medical Medicare Allowed Amount | 76425.94 |
| Total Medical Medicare Payment Amount | 53039.75 |
| Total Medical Medicare Standardized Payment Amount | 54899.37 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 110 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 128 |
| Number Of Male Beneficiaries | 153 |
| 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 | 237 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0047 |