National Provider Identifier [NPI]: |
1134264427 |
Last Name Of The Provider |
MCCALLUM |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1521 E TANGERINE RD |
Street Address 2 Of The Provider |
SUITE 283 |
City Of The Provider |
ORO VALLEY |
Zip Code Of The Provider |
857556225 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
1434 |
Number Of Medicare Beneficiaries |
753 |
Total Submitted Charge Amount |
499370 |
Total Medicare Allowed Amount |
238859.5 |
Total Medicare Payment Amount |
183766.38 |
Total Medicare Standardized Payment Amount |
186241.65 |
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 |
33 |
Number Of Medical Services |
1434 |
Number Of Medicare Beneficiaries With Medical Services |
753 |
Total Medical Submitted Charge Amount |
499370 |
Total Medical Medicare Allowed Amount |
238859.5 |
Total Medical Medicare Payment Amount |
183766.38 |
Total Medical Medicare Standardized Payment Amount |
186241.65 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
432 |
Number Of Beneficiaries Age 75 to 84 |
254 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
409 |
Number Of Male Beneficiaries |
344 |
Number Of Non Hispanic White Beneficiaries |
690 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
31 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
730 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.8452 |