| National Provider Identifier [NPI]: | 1457437469 |
| Last Name Of The Provider | SALLACH |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1701 SOUTH BOULEVARD E |
| Street Address 2 Of The Provider | SUITE 390 |
| City Of The Provider | ROCHESTER HILLS |
| Zip Code Of The Provider | 483076117 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 3298 |
| Number Of Medicare Beneficiaries | 1400 |
| Total Submitted Charge Amount | 667654 |
| Total Medicare Allowed Amount | 349773.76 |
| Total Medicare Payment Amount | 262781.49 |
| Total Medicare Standardized Payment Amount | 259906.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 328 |
| Number Of Medicare Beneficiaries With Drug Services | 100 |
| Total Drug Submitted ChargeAmount | 24993 |
| Total Drug Medicare AllowedAmount | 16684.21 |
| Total Drug Medicare PaymentAmount | 13076 |
| Total Drug Medicare Standardized Payment Amount | 13076 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 2970 |
| Number Of Medicare Beneficiaries With Medical Services | 1400 |
| Total Medical Submitted Charge Amount | 642661 |
| Total Medical Medicare Allowed Amount | 333089.55 |
| Total Medical Medicare Payment Amount | 249705.49 |
| Total Medical Medicare Standardized Payment Amount | 246830.49 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 100 |
| Number Of Beneficiaries Age 65 to 74 | 504 |
| Number Of Beneficiaries Age 75 to 84 | 523 |
| Number Of Beneficiaries Age Greater 84 | 273 |
| Number Of Female Beneficiaries | 709 |
| Number Of Male Beneficiaries | 691 |
| Number Of Non Hispanic White Beneficiaries | 1303 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1245 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 155 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6248 |