| National Provider Identifier [NPI]: | 1144234766 |
| Last Name Of The Provider | CALVY |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2875 S 171ST ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW BERLIN |
| Zip Code Of The Provider | 531513511 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 159 |
| Number Of Services | 3550 |
| Number Of Medicare Beneficiaries | 2397 |
| Total Submitted Charge Amount | 1092303 |
| Total Medicare Allowed Amount | 112665.52 |
| Total Medicare Payment Amount | 81162.04 |
| Total Medicare Standardized Payment Amount | 87271.61 |
| Drug Suppress Indicator | * |
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| Number Of Medicare Beneficiaries With Drug Services | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 463 |
| Number Of Beneficiaries Age 65 to 74 | 675 |
| Number Of Beneficiaries Age 75 to 84 | 721 |
| Number Of Beneficiaries Age Greater 84 | 538 |
| Number Of Female Beneficiaries | 1460 |
| Number Of Male Beneficiaries | 937 |
| Number Of Non Hispanic White Beneficiaries | 2048 |
| Number Of Black or African American Beneficiaries | 168 |
| Number Of AsianPacific Islander Beneficiaries | 32 |
| Number Of Hispanic Beneficiaries | 109 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1691 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 706 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9316 |