| National Provider Identifier [NPI]: | 1477548808 |
| Last Name Of The Provider | CALLAHAN |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D., LLC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7978 COOPER CREEK BLVD |
| Street Address 2 Of The Provider | SUITE 204 |
| City Of The Provider | UNIVERSITY PARK |
| Zip Code Of The Provider | 342012141 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 61 |
| Number Of Services | 3668 |
| Number Of Medicare Beneficiaries | 1213 |
| Total Submitted Charge Amount | 387466.48 |
| Total Medicare Allowed Amount | 215701.37 |
| Total Medicare Payment Amount | 156759.12 |
| Total Medicare Standardized Payment Amount | 152394.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 3426.71 |
| Total Drug Medicare AllowedAmount | 2580.84 |
| Total Drug Medicare PaymentAmount | 1991.48 |
| Total Drug Medicare Standardized Payment Amount | 1991.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 3646 |
| Number Of Medicare Beneficiaries With Medical Services | 1213 |
| Total Medical Submitted Charge Amount | 384039.77 |
| Total Medical Medicare Allowed Amount | 213120.53 |
| Total Medical Medicare Payment Amount | 154767.64 |
| Total Medical Medicare Standardized Payment Amount | 150402.56 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 672 |
| Number Of Beneficiaries Age 75 to 84 | 387 |
| Number Of Beneficiaries Age Greater 84 | 135 |
| Number Of Female Beneficiaries | 701 |
| Number Of Male Beneficiaries | 512 |
| Number Of Non Hispanic White Beneficiaries | 1173 |
| Number Of Black or African American Beneficiaries | |
| 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 | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8694 |