| National Provider Identifier [NPI]: | 1407898505 |
| Last Name Of The Provider | MCCOLLUM |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3410 WORTH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752462003 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 133 |
| Number Of Services | 484606 |
| Number Of Medicare Beneficiaries | 352 |
| Total Submitted Charge Amount | 10667562 |
| Total Medicare Allowed Amount | 2707828.49 |
| Total Medicare Payment Amount | 2118547.79 |
| Total Medicare Standardized Payment Amount | 2125181.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 52 |
| Number Of Drug Services | 472804 |
| Number Of Medicare Beneficiaries With Drug Services | 175 |
| Total Drug Submitted ChargeAmount | 8005017 |
| Total Drug Medicare AllowedAmount | 2000453.1 |
| Total Drug Medicare PaymentAmount | 1563502.03 |
| Total Drug Medicare Standardized Payment Amount | 1563502.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 81 |
| Number Of Medical Services | 11802 |
| Number Of Medicare Beneficiaries With Medical Services | 352 |
| Total Medical Submitted Charge Amount | 2662545 |
| Total Medical Medicare Allowed Amount | 707375.39 |
| Total Medical Medicare Payment Amount | 555045.76 |
| Total Medical Medicare Standardized Payment Amount | 561679.02 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 177 |
| Number Of Beneficiaries Age 75 to 84 | 121 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 160 |
| Number Of Male Beneficiaries | 192 |
| Number Of Non Hispanic White Beneficiaries | 268 |
| Number Of Black or African American Beneficiaries | 58 |
| 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 | 317 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 59 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.8998 |