National Provider Identifier [NPI]: |
1538334420 |
Last Name Of The Provider |
SALEM |
First Name Of The Provider |
GALENA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
617 23RD ST STE 19 |
Street Address 2 Of The Provider |
|
City Of The Provider |
ASHLAND |
Zip Code Of The Provider |
411012845 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
982 |
Number Of Medicare Beneficiaries |
317 |
Total Submitted Charge Amount |
256472 |
Total Medicare Allowed Amount |
107654.91 |
Total Medicare Payment Amount |
79436.02 |
Total Medicare Standardized Payment Amount |
85563.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
7 |
Number Of Medical Services |
982 |
Number Of Medicare Beneficiaries With Medical Services |
317 |
Total Medical Submitted Charge Amount |
256472 |
Total Medical Medicare Allowed Amount |
107654.91 |
Total Medical Medicare Payment Amount |
79436.02 |
Total Medical Medicare Standardized Payment Amount |
85563.16 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
129 |
Number Of Beneficiaries Age 75 to 84 |
100 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
180 |
Number Of Male Beneficiaries |
137 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
238 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
79 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
49 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.0976 |