National Provider Identifier [NPI]: |
1487611620 |
Last Name Of The Provider |
CALLEWART |
First Name Of The Provider |
CRAIG |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9101 N CENTRAL EXPY |
Street Address 2 Of The Provider |
SUITE 360 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752315927 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
89 |
Number Of Services |
2641 |
Number Of Medicare Beneficiaries |
342 |
Total Submitted Charge Amount |
800046.49 |
Total Medicare Allowed Amount |
534148.5 |
Total Medicare Payment Amount |
406911.67 |
Total Medicare Standardized Payment Amount |
390203.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
39 |
Number Of Medicare Beneficiaries With Drug Services |
27 |
Total Drug Submitted ChargeAmount |
765 |
Total Drug Medicare AllowedAmount |
196.11 |
Total Drug Medicare PaymentAmount |
153.72 |
Total Drug Medicare Standardized Payment Amount |
153.72 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
87 |
Number Of Medical Services |
2602 |
Number Of Medicare Beneficiaries With Medical Services |
342 |
Total Medical Submitted Charge Amount |
799281.49 |
Total Medical Medicare Allowed Amount |
533952.39 |
Total Medical Medicare Payment Amount |
406757.95 |
Total Medical Medicare Standardized Payment Amount |
390049.78 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
219 |
Number Of Male Beneficiaries |
123 |
Number Of Non Hispanic White Beneficiaries |
296 |
Number Of Black or African American Beneficiaries |
30 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
310 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1375 |