| National Provider Identifier [NPI]: | 1174619068 |
| Last Name Of The Provider | COLE |
| First Name Of The Provider | LARRY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3245 INTERNATIONAL CIR |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | COLORADO SPRINGS |
| Zip Code Of The Provider | 809103152 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 6520 |
| Number Of Medicare Beneficiaries | 1025 |
| Total Submitted Charge Amount | 378900 |
| Total Medicare Allowed Amount | 208001.17 |
| Total Medicare Payment Amount | 146943.43 |
| Total Medicare Standardized Payment Amount | 140632.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1233 |
| Number Of Medicare Beneficiaries With Drug Services | 118 |
| Total Drug Submitted ChargeAmount | 5559 |
| Total Drug Medicare AllowedAmount | 2332.28 |
| Total Drug Medicare PaymentAmount | 1559.02 |
| Total Drug Medicare Standardized Payment Amount | 1559.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 5287 |
| Number Of Medicare Beneficiaries With Medical Services | 1025 |
| Total Medical Submitted Charge Amount | 373341 |
| Total Medical Medicare Allowed Amount | 205668.89 |
| Total Medical Medicare Payment Amount | 145384.41 |
| Total Medical Medicare Standardized Payment Amount | 139073.03 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 399 |
| Number Of Beneficiaries Age 75 to 84 | 400 |
| Number Of Beneficiaries Age Greater 84 | 180 |
| Number Of Female Beneficiaries | 502 |
| Number Of Male Beneficiaries | 523 |
| Number Of Non Hispanic White Beneficiaries | 982 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 971 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.9074 |