| National Provider Identifier [NPI]: | 1104830884 |
| Last Name Of The Provider | CALL |
| First Name Of The Provider | NATHAN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1652 S MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOGAN |
| Zip Code Of The Provider | 843218504 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 1275 |
| Number Of Medicare Beneficiaries | 195 |
| Total Submitted Charge Amount | 58709 |
| Total Medicare Allowed Amount | 41443.09 |
| Total Medicare Payment Amount | 26850.25 |
| Total Medicare Standardized Payment Amount | 28365.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 488 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 1555 |
| Total Drug Medicare AllowedAmount | 1238.6 |
| Total Drug Medicare PaymentAmount | 1118.89 |
| Total Drug Medicare Standardized Payment Amount | 1118.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 787 |
| Number Of Medicare Beneficiaries With Medical Services | 195 |
| Total Medical Submitted Charge Amount | 57154 |
| Total Medical Medicare Allowed Amount | 40204.49 |
| Total Medical Medicare Payment Amount | 25731.36 |
| Total Medical Medicare Standardized Payment Amount | 27246.9 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 98 |
| Number Of Beneficiaries Age 75 to 84 | 60 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 98 |
| Number Of Male Beneficiaries | 97 |
| Number Of Non Hispanic White Beneficiaries | 182 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 179 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 23 |
| Percent Of With Hypertension | 34 |
| Percent Of With Ischemic Heart Disease | 13 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7658 |