| National Provider Identifier [NPI]: | 1093761363 |
| Last Name Of The Provider | SALAMAN |
| First Name Of The Provider | ERICA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1841 W 19TH ST |
| Street Address 2 Of The Provider | 2R |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606082713 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 247 |
| Number Of Medicare Beneficiaries | 206 |
| Total Submitted Charge Amount | 114995 |
| Total Medicare Allowed Amount | 29357.07 |
| Total Medicare Payment Amount | 22351.41 |
| Total Medicare Standardized Payment Amount | 23086.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 247 |
| Number Of Medicare Beneficiaries With Medical Services | 206 |
| Total Medical Submitted Charge Amount | 114995 |
| Total Medical Medicare Allowed Amount | 29357.07 |
| Total Medical Medicare Payment Amount | 22351.41 |
| Total Medical Medicare Standardized Payment Amount | 23086.04 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 54 |
| Number Of Beneficiaries Age 75 to 84 | 55 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 111 |
| Number Of Male Beneficiaries | 95 |
| Number Of Non Hispanic White Beneficiaries | 165 |
| Number Of Black or African American Beneficiaries | 28 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 147 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8301 |