| National Provider Identifier [NPI]: | 1043209596 |
| Last Name Of The Provider | KALLAY |
| First Name Of The Provider | NICHOLAS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 521 PARK HILL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | FREDERICKSBURG |
| Zip Code Of The Provider | 224013377 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 2008 |
| Number Of Medicare Beneficiaries | 747 |
| Total Submitted Charge Amount | 343638.48 |
| Total Medicare Allowed Amount | 199384.98 |
| Total Medicare Payment Amount | 152396.46 |
| Total Medicare Standardized Payment Amount | 155774.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 37 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 2739.48 |
| Total Drug Medicare AllowedAmount | 2654.61 |
| Total Drug Medicare PaymentAmount | 2601.56 |
| Total Drug Medicare Standardized Payment Amount | 2601.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 1971 |
| Number Of Medicare Beneficiaries With Medical Services | 747 |
| Total Medical Submitted Charge Amount | 340899 |
| Total Medical Medicare Allowed Amount | 196730.37 |
| Total Medical Medicare Payment Amount | 149794.9 |
| Total Medical Medicare Standardized Payment Amount | 153173.1 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 107 |
| Number Of Beneficiaries Age 65 to 74 | 321 |
| Number Of Beneficiaries Age 75 to 84 | 224 |
| Number Of Beneficiaries Age Greater 84 | 95 |
| Number Of Female Beneficiaries | 415 |
| Number Of Male Beneficiaries | 332 |
| Number Of Non Hispanic White Beneficiaries | 622 |
| Number Of Black or African American Beneficiaries | 105 |
| 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 | 609 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 138 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 23 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 53 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.1862 |