| National Provider Identifier [NPI]: | 1952593170 |
| Last Name Of The Provider | SALOM |
| First Name Of The Provider | IVY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4306 ALTON RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MIAMI BEACH |
| Zip Code Of The Provider | 331402840 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 132 |
| Number Of Services | 5353 |
| Number Of Medicare Beneficiaries | 3024 |
| Total Submitted Charge Amount | 622217 |
| Total Medicare Allowed Amount | 152640.12 |
| Total Medicare Payment Amount | 118818 |
| Total Medicare Standardized Payment Amount | 110369.77 |
| 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 | 132 |
| Number Of Medical Services | 5353 |
| Number Of Medicare Beneficiaries With Medical Services | 3024 |
| Total Medical Submitted Charge Amount | 622217 |
| Total Medical Medicare Allowed Amount | 152640.12 |
| Total Medical Medicare Payment Amount | 118818 |
| Total Medical Medicare Standardized Payment Amount | 110369.77 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 361 |
| Number Of Beneficiaries Age 65 to 74 | 970 |
| Number Of Beneficiaries Age 75 to 84 | 950 |
| Number Of Beneficiaries Age Greater 84 | 743 |
| Number Of Female Beneficiaries | 1699 |
| Number Of Male Beneficiaries | 1325 |
| Number Of Non Hispanic White Beneficiaries | 1672 |
| Number Of Black or African American Beneficiaries | 216 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 1073 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1691 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1333 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.0901 |