| National Provider Identifier [NPI]: | 1669475760 |
| Last Name Of The Provider | KALLAB |
| First Name Of The Provider | ANDRE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1240 JESSE JEWELL PKWY SE |
| Street Address 2 Of The Provider | STE 500 |
| City Of The Provider | GAINESVILLE |
| Zip Code Of The Provider | 305013861 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 215 |
| Number Of Services | 187750 |
| Number Of Medicare Beneficiaries | 608 |
| Total Submitted Charge Amount | 9268000.04 |
| Total Medicare Allowed Amount | 3227265.19 |
| Total Medicare Payment Amount | 2462927.66 |
| Total Medicare Standardized Payment Amount | 2515907.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 77 |
| Number Of Drug Services | 168885 |
| Number Of Medicare Beneficiaries With Drug Services | 310 |
| Total Drug Submitted ChargeAmount | 6968608.04 |
| Total Drug Medicare AllowedAmount | 2542763.55 |
| Total Drug Medicare PaymentAmount | 1918662.86 |
| Total Drug Medicare Standardized Payment Amount | 1918662.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 138 |
| Number Of Medical Services | 18865 |
| Number Of Medicare Beneficiaries With Medical Services | 608 |
| Total Medical Submitted Charge Amount | 2299392 |
| Total Medical Medicare Allowed Amount | 684501.64 |
| Total Medical Medicare Payment Amount | 544264.8 |
| Total Medical Medicare Standardized Payment Amount | 597244.99 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 241 |
| Number Of Beneficiaries Age 75 to 84 | 247 |
| Number Of Beneficiaries Age Greater 84 | 70 |
| Number Of Female Beneficiaries | 351 |
| Number Of Male Beneficiaries | 257 |
| Number Of Non Hispanic White Beneficiaries | 585 |
| 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 | 538 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 51 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.8528 |