| National Provider Identifier [NPI]: | 1578510772 |
| Last Name Of The Provider | SALBER |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1055 N CURTIS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BOISE |
| Zip Code Of The Provider | 837061309 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 187 |
| Number Of Services | 6902 |
| Number Of Medicare Beneficiaries | 1844 |
| Total Submitted Charge Amount | 275670.91 |
| Total Medicare Allowed Amount | 129720.4 |
| Total Medicare Payment Amount | 95756.14 |
| Total Medicare Standardized Payment Amount | 102433.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 4489 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 1588.22 |
| Total Drug Medicare AllowedAmount | 1452.63 |
| Total Drug Medicare PaymentAmount | 1069.17 |
| Total Drug Medicare Standardized Payment Amount | 1069.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 180 |
| Number Of Medical Services | 2413 |
| Number Of Medicare Beneficiaries With Medical Services | 1843 |
| Total Medical Submitted Charge Amount | 274082.69 |
| Total Medical Medicare Allowed Amount | 128267.77 |
| Total Medical Medicare Payment Amount | 94686.97 |
| Total Medical Medicare Standardized Payment Amount | 101364.32 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 375 |
| Number Of Beneficiaries Age 65 to 74 | 603 |
| Number Of Beneficiaries Age 75 to 84 | 571 |
| Number Of Beneficiaries Age Greater 84 | 295 |
| Number Of Female Beneficiaries | 1031 |
| Number Of Male Beneficiaries | 813 |
| Number Of Non Hispanic White Beneficiaries | 1671 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 120 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1282 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 562 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6122 |