| National Provider Identifier [NPI]: | 1083614531 |
| Last Name Of The Provider | KALLAL |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 RETREAT AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | HARTFORD |
| Zip Code Of The Provider | 061062528 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 5542 |
| Number Of Medicare Beneficiaries | 2449 |
| Total Submitted Charge Amount | 902553 |
| Total Medicare Allowed Amount | 307819.19 |
| Total Medicare Payment Amount | 221940.61 |
| Total Medicare Standardized Payment Amount | 205356.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 46 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 4210 |
| Total Drug Medicare AllowedAmount | 1939.68 |
| Total Drug Medicare PaymentAmount | 1520.71 |
| Total Drug Medicare Standardized Payment Amount | 1520.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 5496 |
| Number Of Medicare Beneficiaries With Medical Services | 2449 |
| Total Medical Submitted Charge Amount | 898343 |
| Total Medical Medicare Allowed Amount | 305879.51 |
| Total Medical Medicare Payment Amount | 220419.9 |
| Total Medical Medicare Standardized Payment Amount | 203835.98 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 316 |
| Number Of Beneficiaries Age 65 to 74 | 735 |
| Number Of Beneficiaries Age 75 to 84 | 837 |
| Number Of Beneficiaries Age Greater 84 | 561 |
| Number Of Female Beneficiaries | 1185 |
| Number Of Male Beneficiaries | 1264 |
| Number Of Non Hispanic White Beneficiaries | 2031 |
| Number Of Black or African American Beneficiaries | 160 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 186 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1738 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 711 |
| Percent Of With Atrial Fibrillation | 34 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8811 |