| National Provider Identifier [NPI]: | 1952300550 |
| Last Name Of The Provider | SALEM |
| First Name Of The Provider | OMAR |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4848 HOLLAND SYLVANIA ROAD |
| Street Address 2 Of The Provider | 201 |
| City Of The Provider | SYLVANIA |
| Zip Code Of The Provider | 43560 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 3511 |
| Number Of Medicare Beneficiaries | 487 |
| Total Submitted Charge Amount | 368083 |
| Total Medicare Allowed Amount | 175071.42 |
| Total Medicare Payment Amount | 122378.2 |
| Total Medicare Standardized Payment Amount | 125471.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 138 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 414 |
| Total Drug Medicare AllowedAmount | 245.78 |
| Total Drug Medicare PaymentAmount | 178.4 |
| Total Drug Medicare Standardized Payment Amount | 178.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 3373 |
| Number Of Medicare Beneficiaries With Medical Services | 487 |
| Total Medical Submitted Charge Amount | 367669 |
| Total Medical Medicare Allowed Amount | 174825.64 |
| Total Medical Medicare Payment Amount | 122199.8 |
| Total Medical Medicare Standardized Payment Amount | 125293.05 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 206 |
| Number Of Beneficiaries Age 75 to 84 | 178 |
| Number Of Beneficiaries Age Greater 84 | 86 |
| Number Of Female Beneficiaries | 246 |
| Number Of Male Beneficiaries | 241 |
| Number Of Non Hispanic White Beneficiaries | 454 |
| Number Of Black or African American Beneficiaries | 13 |
| 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 | 462 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0249 |