| National Provider Identifier [NPI]: | 1104851393 |
| Last Name Of The Provider | CALLANAN |
| First Name Of The Provider | JOSEPH |
| 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 | 1000 N CURTIS RD |
| Street Address 2 Of The Provider | SUITE 303 |
| City Of The Provider | BOISE |
| Zip Code Of The Provider | 837061337 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 3765.3 |
| Number Of Medicare Beneficiaries | 141 |
| Total Submitted Charge Amount | 75941.75 |
| Total Medicare Allowed Amount | 46908.44 |
| Total Medicare Payment Amount | 34368.95 |
| Total Medicare Standardized Payment Amount | 35522.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 450.4 |
| Total Drug Medicare AllowedAmount | 182.82 |
| Total Drug Medicare PaymentAmount | 166.85 |
| Total Drug Medicare Standardized Payment Amount | 166.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 3739.3 |
| Number Of Medicare Beneficiaries With Medical Services | 141 |
| Total Medical Submitted Charge Amount | 75491.35 |
| Total Medical Medicare Allowed Amount | 46725.62 |
| Total Medical Medicare Payment Amount | 34202.1 |
| Total Medical Medicare Standardized Payment Amount | 35355.74 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 76 |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 92 |
| Number Of Male Beneficiaries | 49 |
| 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 | 128 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 30 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 10 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8047 |