| National Provider Identifier [NPI]: | 1881735280 |
| Last Name Of The Provider | SALEH |
| First Name Of The Provider | KHALED |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 747 N RUTLEDGE ST |
| Street Address 2 Of The Provider | 5TH FLOOR |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 627026700 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 936 |
| Number Of Medicare Beneficiaries | 316 |
| Total Submitted Charge Amount | 1130070 |
| Total Medicare Allowed Amount | 173080.6 |
| Total Medicare Payment Amount | 128774.99 |
| Total Medicare Standardized Payment Amount | 133134.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 144 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 19236 |
| Total Drug Medicare AllowedAmount | 6039.94 |
| Total Drug Medicare PaymentAmount | 4656.31 |
| Total Drug Medicare Standardized Payment Amount | 4656.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 792 |
| Number Of Medicare Beneficiaries With Medical Services | 316 |
| Total Medical Submitted Charge Amount | 1110834 |
| Total Medical Medicare Allowed Amount | 167040.66 |
| Total Medical Medicare Payment Amount | 124118.68 |
| Total Medical Medicare Standardized Payment Amount | 128478.36 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 121 |
| Number Of Beneficiaries Age 65 to 74 | 117 |
| Number Of Beneficiaries Age 75 to 84 | 60 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 207 |
| Number Of Male Beneficiaries | 109 |
| Number Of Non Hispanic White Beneficiaries | 269 |
| 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 | 182 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 134 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4614 |