| National Provider Identifier [NPI]: | 1821173311 |
| Last Name Of The Provider | SALVA-OTERO |
| First Name Of The Provider | ROBERTO |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 488 NEWTON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTH HADLEY |
| Zip Code Of The Provider | 010752010 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 1101 |
| Number Of Medicare Beneficiaries | 217 |
| Total Submitted Charge Amount | 118066 |
| Total Medicare Allowed Amount | 75232.33 |
| Total Medicare Payment Amount | 48727.9 |
| Total Medicare Standardized Payment Amount | 50295.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 49 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 303 |
| Total Drug Medicare AllowedAmount | 82.72 |
| Total Drug Medicare PaymentAmount | 59.39 |
| Total Drug Medicare Standardized Payment Amount | 59.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 1052 |
| Number Of Medicare Beneficiaries With Medical Services | 217 |
| Total Medical Submitted Charge Amount | 117763 |
| Total Medical Medicare Allowed Amount | 75149.61 |
| Total Medical Medicare Payment Amount | 48668.51 |
| Total Medical Medicare Standardized Payment Amount | 50236.59 |
| Average Age Of Beneficiaries | 58 |
| Number Of Beneficiaries Age Less65 | 136 |
| Number Of Beneficiaries Age 65 to 74 | 52 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 117 |
| Number Of Male Beneficiaries | 100 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 150 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 34 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 183 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 18 |
| Percent Of With Hypertension | 39 |
| Percent Of With Ischemic Heart Disease | 12 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0677 |