| National Provider Identifier [NPI]: | 1013059625 |
| Last Name Of The Provider | CALLAHAN |
| First Name Of The Provider | BRIAN |
| 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 | 2200 BERGQUIST DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | LACKLAND A F B |
| Zip Code Of The Provider | 782369907 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 176 |
| Number Of Services | 4177 |
| Number Of Medicare Beneficiaries | 2912 |
| Total Submitted Charge Amount | 643721 |
| Total Medicare Allowed Amount | 141108.84 |
| Total Medicare Payment Amount | 109468.21 |
| Total Medicare Standardized Payment Amount | 109002.9 |
| 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 | 176 |
| Number Of Medical Services | 4177 |
| Number Of Medicare Beneficiaries With Medical Services | 2912 |
| Total Medical Submitted Charge Amount | 643721 |
| Total Medical Medicare Allowed Amount | 141108.84 |
| Total Medical Medicare Payment Amount | 109468.21 |
| Total Medical Medicare Standardized Payment Amount | 109002.9 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 481 |
| Number Of Beneficiaries Age 65 to 74 | 1189 |
| Number Of Beneficiaries Age 75 to 84 | 871 |
| Number Of Beneficiaries Age Greater 84 | 371 |
| Number Of Female Beneficiaries | 1712 |
| Number Of Male Beneficiaries | 1200 |
| Number Of Non Hispanic White Beneficiaries | 2212 |
| Number Of Black or African American Beneficiaries | 588 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 56 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2233 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 679 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6378 |