| National Provider Identifier [NPI]: | 1669658969 |
| Last Name Of The Provider | MCCOLLAUM |
| First Name Of The Provider | REBECCA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | A.P.R.N. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 S DOBSON RD STE C26 |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHANDLER |
| Zip Code Of The Provider | 852245690 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 110 |
| Number Of Medicare Beneficiaries | 80 |
| Total Submitted Charge Amount | 6486.81 |
| Total Medicare Allowed Amount | 5037.45 |
| Total Medicare Payment Amount | 3293.51 |
| Total Medicare Standardized Payment Amount | 4156.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 18 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 696.82 |
| Total Drug Medicare AllowedAmount | 575.19 |
| Total Drug Medicare PaymentAmount | 563.64 |
| Total Drug Medicare Standardized Payment Amount | 563.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 92 |
| Number Of Medicare Beneficiaries With Medical Services | 80 |
| Total Medical Submitted Charge Amount | 5789.99 |
| Total Medical Medicare Allowed Amount | 4462.26 |
| Total Medical Medicare Payment Amount | 2729.87 |
| Total Medical Medicare Standardized Payment Amount | 3592.92 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 43 |
| Number Of Beneficiaries Age 75 to 84 | 19 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 45 |
| Number Of Male Beneficiaries | 35 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| 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 | 14 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7706 |