| National Provider Identifier [NPI]: | 1497999148 |
| Last Name Of The Provider | SALSAMENDI |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1611 NW 12TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MIAMI |
| Zip Code Of The Provider | 331361005 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 124 |
| Number Of Services | 850 |
| Number Of Medicare Beneficiaries | 233 |
| Total Submitted Charge Amount | 790645 |
| Total Medicare Allowed Amount | 92962.31 |
| Total Medicare Payment Amount | 71861.95 |
| Total Medicare Standardized Payment Amount | 63678.47 |
| 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 | 124 |
| Number Of Medical Services | 850 |
| Number Of Medicare Beneficiaries With Medical Services | 233 |
| Total Medical Submitted Charge Amount | 790645 |
| Total Medical Medicare Allowed Amount | 92962.31 |
| Total Medical Medicare Payment Amount | 71861.95 |
| Total Medical Medicare Standardized Payment Amount | 63678.47 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 96 |
| Number Of Beneficiaries Age 65 to 74 | 85 |
| Number Of Beneficiaries Age 75 to 84 | 37 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 126 |
| Number Of Male Beneficiaries | 107 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 83 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 96 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 65 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 168 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 67 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 61 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 4.0218 |