| National Provider Identifier [NPI]: | 1407835937 |
| Last Name Of The Provider | BAVUSO |
| First Name Of The Provider | SALVATORE |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 36 LIVELY OAKS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LIVELY |
| Zip Code Of The Provider | 22507 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 2438 |
| Number Of Medicare Beneficiaries | 764 |
| Total Submitted Charge Amount | 189858.49 |
| Total Medicare Allowed Amount | 151105.07 |
| Total Medicare Payment Amount | 104269.5 |
| Total Medicare Standardized Payment Amount | 107477.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 269 |
| Number Of Medicare Beneficiaries With Drug Services | 171 |
| Total Drug Submitted ChargeAmount | 10858.49 |
| Total Drug Medicare AllowedAmount | 9673.59 |
| Total Drug Medicare PaymentAmount | 9376.37 |
| Total Drug Medicare Standardized Payment Amount | 9376.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 2169 |
| Number Of Medicare Beneficiaries With Medical Services | 764 |
| Total Medical Submitted Charge Amount | 179000 |
| Total Medical Medicare Allowed Amount | 141431.48 |
| Total Medical Medicare Payment Amount | 94893.13 |
| Total Medical Medicare Standardized Payment Amount | 98101.61 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 78 |
| Number Of Beneficiaries Age 65 to 74 | 237 |
| Number Of Beneficiaries Age 75 to 84 | 269 |
| Number Of Beneficiaries Age Greater 84 | 180 |
| Number Of Female Beneficiaries | 452 |
| Number Of Male Beneficiaries | 312 |
| Number Of Non Hispanic White Beneficiaries | 627 |
| 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 | 631 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 133 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2814 |