| National Provider Identifier [NPI]: | 1205874831 |
| Last Name Of The Provider | SALLOUM |
| First Name Of The Provider | FADI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 50 N PERRY ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PONTIAC |
| Zip Code Of The Provider | 483422217 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 1570 |
| Number Of Medicare Beneficiaries | 921 |
| Total Submitted Charge Amount | 267805 |
| Total Medicare Allowed Amount | 186347.54 |
| Total Medicare Payment Amount | 142561.63 |
| Total Medicare Standardized Payment Amount | 138047 |
| 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 | 29 |
| Number Of Medical Services | 1570 |
| Number Of Medicare Beneficiaries With Medical Services | 921 |
| Total Medical Submitted Charge Amount | 267805 |
| Total Medical Medicare Allowed Amount | 186347.54 |
| Total Medical Medicare Payment Amount | 142561.63 |
| Total Medical Medicare Standardized Payment Amount | 138047 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 126 |
| Number Of Beneficiaries Age 65 to 74 | 195 |
| Number Of Beneficiaries Age 75 to 84 | 277 |
| Number Of Beneficiaries Age Greater 84 | 323 |
| Number Of Female Beneficiaries | 569 |
| Number Of Male Beneficiaries | 352 |
| Number Of Non Hispanic White Beneficiaries | 768 |
| Number Of Black or African American Beneficiaries | 119 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 528 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 393 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 63 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 64 |
| Percent Of With Chronic Kidney Disease | 61 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 45 |
| Percent Of With Depression | 54 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 24 |
| Average HCC Risk Score Of Beneficiaries | 2.6791 |