National Provider Identifier [NPI]: |
1366648164 |
Last Name Of The Provider |
MCCALL |
First Name Of The Provider |
MATTHEW |
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 |
5673 PEACHTREE DUNWOODY RD NE |
Street Address 2 Of The Provider |
STE. 330 |
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
303421731 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
33347 |
Number Of Medicare Beneficiaries |
370 |
Total Submitted Charge Amount |
844865 |
Total Medicare Allowed Amount |
277365.42 |
Total Medicare Payment Amount |
214765.54 |
Total Medicare Standardized Payment Amount |
215607.9 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
31397 |
Number Of Medicare Beneficiaries With Drug Services |
37 |
Total Drug Submitted ChargeAmount |
128632 |
Total Drug Medicare AllowedAmount |
43322.94 |
Total Drug Medicare PaymentAmount |
33807.01 |
Total Drug Medicare Standardized Payment Amount |
33807.01 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
1950 |
Number Of Medicare Beneficiaries With Medical Services |
370 |
Total Medical Submitted Charge Amount |
716233 |
Total Medical Medicare Allowed Amount |
234042.48 |
Total Medical Medicare Payment Amount |
180958.53 |
Total Medical Medicare Standardized Payment Amount |
181800.89 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
117 |
Number Of Beneficiaries Age 75 to 84 |
102 |
Number Of Beneficiaries Age Greater 84 |
80 |
Number Of Female Beneficiaries |
187 |
Number Of Male Beneficiaries |
183 |
Number Of Non Hispanic White Beneficiaries |
290 |
Number Of Black or African American Beneficiaries |
63 |
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 |
312 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
67 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.9599 |