| National Provider Identifier [NPI]: | 1265540355 |
| Last Name Of The Provider | CALLAHAN |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1240 E 100 S |
| Street Address 2 Of The Provider | SUITE 15A |
| City Of The Provider | ST GEORGE |
| Zip Code Of The Provider | 847903001 |
| 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 | 58 |
| Number Of Services | 4305 |
| Number Of Medicare Beneficiaries | 856 |
| Total Submitted Charge Amount | 214927 |
| Total Medicare Allowed Amount | 191340.73 |
| Total Medicare Payment Amount | 136170.69 |
| Total Medicare Standardized Payment Amount | 142688.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 1046 |
| Number Of Medicare Beneficiaries With Drug Services | 239 |
| Total Drug Submitted ChargeAmount | 17302 |
| Total Drug Medicare AllowedAmount | 9871.21 |
| Total Drug Medicare PaymentAmount | 8837.96 |
| Total Drug Medicare Standardized Payment Amount | 8837.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 3259 |
| Number Of Medicare Beneficiaries With Medical Services | 856 |
| Total Medical Submitted Charge Amount | 197625 |
| Total Medical Medicare Allowed Amount | 181469.52 |
| Total Medical Medicare Payment Amount | 127332.73 |
| Total Medical Medicare Standardized Payment Amount | 133850.1 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 85 |
| Number Of Beneficiaries Age 65 to 74 | 385 |
| Number Of Beneficiaries Age 75 to 84 | 248 |
| Number Of Beneficiaries Age Greater 84 | 138 |
| Number Of Female Beneficiaries | 483 |
| Number Of Male Beneficiaries | 373 |
| Number Of Non Hispanic White Beneficiaries | 837 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 761 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 95 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 31 |
| Percent Of With Hypertension | 42 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9936 |