| National Provider Identifier [NPI]: | 1912937939 |
| Last Name Of The Provider | COLIN |
| First Name Of The Provider | WAYNE |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | D.M.D., M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1221 S BROADWAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | LEXINGTON |
| Zip Code Of The Provider | 405042701 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Otolaryngology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 121 |
| Number Of Services | 1022 |
| Number Of Medicare Beneficiaries | 403 |
| Total Submitted Charge Amount | 568559 |
| Total Medicare Allowed Amount | 191951.75 |
| Total Medicare Payment Amount | 145933.53 |
| Total Medicare Standardized Payment Amount | 157526.58 |
| 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 | 121 |
| Number Of Medical Services | 1022 |
| Number Of Medicare Beneficiaries With Medical Services | 403 |
| Total Medical Submitted Charge Amount | 568559 |
| Total Medical Medicare Allowed Amount | 191951.75 |
| Total Medical Medicare Payment Amount | 145933.53 |
| Total Medical Medicare Standardized Payment Amount | 157526.58 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 85 |
| Number Of Beneficiaries Age 65 to 74 | 159 |
| Number Of Beneficiaries Age 75 to 84 | 121 |
| Number Of Beneficiaries Age Greater 84 | 38 |
| Number Of Female Beneficiaries | 201 |
| Number Of Male Beneficiaries | 202 |
| Number Of Non Hispanic White Beneficiaries | 370 |
| 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 | 332 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 71 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.145 |