National Provider Identifier [NPI]: |
1548567407 |
Last Name Of The Provider |
SALAMA |
First Name Of The Provider |
NANCY |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3200 KEARNEY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
FREMONT |
Zip Code Of The Provider |
945382299 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
1023 |
Number Of Medicare Beneficiaries |
272 |
Total Submitted Charge Amount |
95462 |
Total Medicare Allowed Amount |
36685.91 |
Total Medicare Payment Amount |
25678.33 |
Total Medicare Standardized Payment Amount |
22886.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
18 |
Number Of Drug Services |
612 |
Number Of Medicare Beneficiaries With Drug Services |
35 |
Total Drug Submitted ChargeAmount |
3520 |
Total Drug Medicare AllowedAmount |
1244.47 |
Total Drug Medicare PaymentAmount |
982.2 |
Total Drug Medicare Standardized Payment Amount |
982.2 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
411 |
Number Of Medicare Beneficiaries With Medical Services |
272 |
Total Medical Submitted Charge Amount |
91942 |
Total Medical Medicare Allowed Amount |
35441.44 |
Total Medical Medicare Payment Amount |
24696.13 |
Total Medical Medicare Standardized Payment Amount |
21904.24 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
161 |
Number Of Male Beneficiaries |
111 |
Number Of Non Hispanic White Beneficiaries |
130 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
68 |
Number Of Hispanic Beneficiaries |
49 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
180 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0881 |