National Provider Identifier [NPI]: |
1134183445 |
Last Name Of The Provider |
SALAMIE |
First Name Of The Provider |
GABRIEL |
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 |
2600 GREENBUSH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAFAYETTE |
Zip Code Of The Provider |
479042477 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
506 |
Number Of Medicare Beneficiaries |
494 |
Total Submitted Charge Amount |
241540 |
Total Medicare Allowed Amount |
40958.94 |
Total Medicare Payment Amount |
28278.5 |
Total Medicare Standardized Payment Amount |
30064.07 |
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 |
37 |
Number Of Medical Services |
506 |
Number Of Medicare Beneficiaries With Medical Services |
494 |
Total Medical Submitted Charge Amount |
241540 |
Total Medical Medicare Allowed Amount |
40958.94 |
Total Medical Medicare Payment Amount |
28278.5 |
Total Medical Medicare Standardized Payment Amount |
30064.07 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
291 |
Number Of Beneficiaries Age 75 to 84 |
88 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
314 |
Number Of Male Beneficiaries |
180 |
Number Of Non Hispanic White Beneficiaries |
472 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
406 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
88 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
2 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
13 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.6849 |