| National Provider Identifier [NPI]: | 1528056488 |
| Last Name Of The Provider | CALLAGHAN |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 N OAK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MARSHFIELD |
| Zip Code Of The Provider | 544495703 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 3500 |
| Number Of Medicare Beneficiaries | 1866 |
| Total Submitted Charge Amount | 809301.4 |
| Total Medicare Allowed Amount | 94499.85 |
| Total Medicare Payment Amount | 69467.67 |
| Total Medicare Standardized Payment Amount | 74437.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 540 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 2412.4 |
| Total Drug Medicare AllowedAmount | 631.75 |
| Total Drug Medicare PaymentAmount | 482.49 |
| Total Drug Medicare Standardized Payment Amount | 482.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 2960 |
| Number Of Medicare Beneficiaries With Medical Services | 1866 |
| Total Medical Submitted Charge Amount | 806889 |
| Total Medical Medicare Allowed Amount | 93868.1 |
| Total Medical Medicare Payment Amount | 68985.18 |
| Total Medical Medicare Standardized Payment Amount | 73954.57 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 408 |
| Number Of Beneficiaries Age 65 to 74 | 751 |
| Number Of Beneficiaries Age 75 to 84 | 494 |
| Number Of Beneficiaries Age Greater 84 | 213 |
| Number Of Female Beneficiaries | 1102 |
| Number Of Male Beneficiaries | 764 |
| Number Of Non Hispanic White Beneficiaries | 1794 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 26 |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1303 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 563 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.4134 |