| National Provider Identifier [NPI]: | 1982672523 |
| Last Name Of The Provider | SALLAVANTI |
| First Name Of The Provider | ARMANDO |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 315 S MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | OLD FORGE |
| Zip Code Of The Provider | 185181606 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 1796 |
| Number Of Medicare Beneficiaries | 450 |
| Total Submitted Charge Amount | 228490 |
| Total Medicare Allowed Amount | 135075.29 |
| Total Medicare Payment Amount | 96563.21 |
| Total Medicare Standardized Payment Amount | 101717.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 139 |
| Number Of Medicare Beneficiaries With Drug Services | 120 |
| Total Drug Submitted ChargeAmount | 9080 |
| Total Drug Medicare AllowedAmount | 3762.72 |
| Total Drug Medicare PaymentAmount | 3589.57 |
| Total Drug Medicare Standardized Payment Amount | 3589.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 1657 |
| Number Of Medicare Beneficiaries With Medical Services | 450 |
| Total Medical Submitted Charge Amount | 219410 |
| Total Medical Medicare Allowed Amount | 131312.57 |
| Total Medical Medicare Payment Amount | 92973.64 |
| Total Medical Medicare Standardized Payment Amount | 98127.77 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 125 |
| Number Of Beneficiaries Age 65 to 74 | 181 |
| Number Of Beneficiaries Age 75 to 84 | 80 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 249 |
| Number Of Male Beneficiaries | 201 |
| Number Of Non Hispanic White Beneficiaries | 434 |
| 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 | 308 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 142 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2219 |