| National Provider Identifier [NPI]: | 1659356533 |
| Last Name Of The Provider | COLBY |
| First Name Of The Provider | JAY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 25 WELLS STREET |
| Street Address 2 Of The Provider | THE WESTERLY HOSPITAL |
| City Of The Provider | WESTERLY |
| Zip Code Of The Provider | 028912460 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 178 |
| Number Of Services | 7176 |
| Number Of Medicare Beneficiaries | 3037 |
| Total Submitted Charge Amount | 887562 |
| Total Medicare Allowed Amount | 224140.98 |
| Total Medicare Payment Amount | 170527.57 |
| Total Medicare Standardized Payment Amount | 167443.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 178 |
| Number Of Medical Services | 7176 |
| Number Of Medicare Beneficiaries With Medical Services | 3037 |
| Total Medical Submitted Charge Amount | 887562 |
| Total Medical Medicare Allowed Amount | 224140.98 |
| Total Medical Medicare Payment Amount | 170527.57 |
| Total Medical Medicare Standardized Payment Amount | 167443.72 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 396 |
| Number Of Beneficiaries Age 65 to 74 | 1075 |
| Number Of Beneficiaries Age 75 to 84 | 944 |
| Number Of Beneficiaries Age Greater 84 | 622 |
| Number Of Female Beneficiaries | 1856 |
| Number Of Male Beneficiaries | 1181 |
| Number Of Non Hispanic White Beneficiaries | 2904 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 52 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2420 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 617 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3813 |