| National Provider Identifier [NPI]: | 1336106681 |
| Last Name Of The Provider | SALAZAR |
| First Name Of The Provider | JORGE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1910 NONCONNAH BLVD |
| Street Address 2 Of The Provider | SUITE 120 |
| City Of The Provider | MEMPHIS |
| Zip Code Of The Provider | 381322113 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 92 |
| Number Of Services | 5498 |
| Number Of Medicare Beneficiaries | 763 |
| Total Submitted Charge Amount | 8981597.41 |
| Total Medicare Allowed Amount | 3841425.09 |
| Total Medicare Payment Amount | 2990107.78 |
| Total Medicare Standardized Payment Amount | 3318239.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 1904 |
| Number Of Medicare Beneficiaries With Drug Services | 496 |
| Total Drug Submitted ChargeAmount | 11424 |
| Total Drug Medicare AllowedAmount | 2350.51 |
| Total Drug Medicare PaymentAmount | 1831.65 |
| Total Drug Medicare Standardized Payment Amount | 1831.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 3594 |
| Number Of Medicare Beneficiaries With Medical Services | 762 |
| Total Medical Submitted Charge Amount | 8970173.41 |
| Total Medical Medicare Allowed Amount | 3839074.58 |
| Total Medical Medicare Payment Amount | 2988276.13 |
| Total Medical Medicare Standardized Payment Amount | 3316407.46 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 370 |
| Number Of Beneficiaries Age 65 to 74 | 231 |
| Number Of Beneficiaries Age 75 to 84 | 113 |
| Number Of Beneficiaries Age Greater 84 | 49 |
| Number Of Female Beneficiaries | 414 |
| Number Of Male Beneficiaries | 349 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 591 |
| 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 | 297 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 466 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 57 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 71 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 2 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 6.3312 |