| National Provider Identifier [NPI]: | 1306845524 |
| Last Name Of The Provider | MCCALL |
| First Name Of The Provider | AUDRA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PAC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2950 S ELM PL |
| Street Address 2 Of The Provider | STE 256 |
| City Of The Provider | BROKEN ARROW |
| Zip Code Of The Provider | 740127877 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 272 |
| Number Of Medicare Beneficiaries | 154 |
| Total Submitted Charge Amount | 37050 |
| Total Medicare Allowed Amount | 16550.39 |
| Total Medicare Payment Amount | 9830.89 |
| Total Medicare Standardized Payment Amount | 13965.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 35 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 468 |
| Total Drug Medicare AllowedAmount | 176.13 |
| Total Drug Medicare PaymentAmount | 160.7 |
| Total Drug Medicare Standardized Payment Amount | 160.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 237 |
| Number Of Medicare Beneficiaries With Medical Services | 154 |
| Total Medical Submitted Charge Amount | 36582 |
| Total Medical Medicare Allowed Amount | 16374.26 |
| Total Medical Medicare Payment Amount | 9670.19 |
| Total Medical Medicare Standardized Payment Amount | 13804.74 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 97 |
| Number Of Beneficiaries Age 75 to 84 | 24 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 89 |
| Number Of Male Beneficiaries | 65 |
| Number Of Non Hispanic White Beneficiaries | 136 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8897 |