| National Provider Identifier [NPI]: | 1821193749 |
| Last Name Of The Provider | SALLEY |
| First Name Of The Provider | FRED |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 310 SANTA FE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | ENCINITAS |
| Zip Code Of The Provider | 920245110 |
| 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 | 99 |
| Number Of Services | 4874 |
| Number Of Medicare Beneficiaries | 417 |
| Total Submitted Charge Amount | 440843.36 |
| Total Medicare Allowed Amount | 207974.15 |
| Total Medicare Payment Amount | 159032.4 |
| Total Medicare Standardized Payment Amount | 155449.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 41 |
| Number Of Drug Services | 3475 |
| Number Of Medicare Beneficiaries With Drug Services | 135 |
| Total Drug Submitted ChargeAmount | 221202.36 |
| Total Drug Medicare AllowedAmount | 101031.76 |
| Total Drug Medicare PaymentAmount | 80361.27 |
| Total Drug Medicare Standardized Payment Amount | 80361.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 1399 |
| Number Of Medicare Beneficiaries With Medical Services | 417 |
| Total Medical Submitted Charge Amount | 219641 |
| Total Medical Medicare Allowed Amount | 106942.39 |
| Total Medical Medicare Payment Amount | 78671.13 |
| Total Medical Medicare Standardized Payment Amount | 75088.33 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 225 |
| Number Of Beneficiaries Age 75 to 84 | 105 |
| Number Of Beneficiaries Age Greater 84 | 61 |
| Number Of Female Beneficiaries | 210 |
| Number Of Male Beneficiaries | 207 |
| Number Of Non Hispanic White Beneficiaries | 379 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 388 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1399 |