| National Provider Identifier [NPI]: | 1699772210 |
| Last Name Of The Provider | GOLLARD |
| First Name Of The Provider | RUSSELL |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 58 N PECOS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | HENDERSON |
| Zip Code Of The Provider | 890747319 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 126 |
| Number Of Services | 207799 |
| Number Of Medicare Beneficiaries | 822 |
| Total Submitted Charge Amount | 6104413.71 |
| Total Medicare Allowed Amount | 2801479.82 |
| Total Medicare Payment Amount | 2139134.68 |
| Total Medicare Standardized Payment Amount | 2134682.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 78 |
| Number Of Drug Services | 190259 |
| Number Of Medicare Beneficiaries With Drug Services | 240 |
| Total Drug Submitted ChargeAmount | 4855529.71 |
| Total Drug Medicare AllowedAmount | 2038006.49 |
| Total Drug Medicare PaymentAmount | 1566397.55 |
| Total Drug Medicare Standardized Payment Amount | 1566397.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 17540 |
| Number Of Medicare Beneficiaries With Medical Services | 822 |
| Total Medical Submitted Charge Amount | 1248884 |
| Total Medical Medicare Allowed Amount | 763473.33 |
| Total Medical Medicare Payment Amount | 572737.13 |
| Total Medical Medicare Standardized Payment Amount | 568285.26 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 108 |
| Number Of Beneficiaries Age 65 to 74 | 398 |
| Number Of Beneficiaries Age 75 to 84 | 244 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 442 |
| Number Of Male Beneficiaries | 380 |
| Number Of Non Hispanic White Beneficiaries | 679 |
| Number Of Black or African American Beneficiaries | 51 |
| Number Of AsianPacific Islander Beneficiaries | 24 |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 726 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 96 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 34 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.9936 |