| National Provider Identifier [NPI]: | 1174545388 |
| Last Name Of The Provider | COLLOM |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 701 ENTERPRISE RD E |
| Street Address 2 Of The Provider | SUITE 910 |
| City Of The Provider | SAFETY HARBOR |
| Zip Code Of The Provider | 346955350 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 8156 |
| Number Of Medicare Beneficiaries | 2578 |
| Total Submitted Charge Amount | 412748.83 |
| Total Medicare Allowed Amount | 392737.35 |
| Total Medicare Payment Amount | 283227.99 |
| Total Medicare Standardized Payment Amount | 285025.15 |
| 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 | 20 |
| Number Of Medical Services | 8156 |
| Number Of Medicare Beneficiaries With Medical Services | 2578 |
| Total Medical Submitted Charge Amount | 412748.83 |
| Total Medical Medicare Allowed Amount | 392737.35 |
| Total Medical Medicare Payment Amount | 283227.99 |
| Total Medical Medicare Standardized Payment Amount | 285025.15 |
| Average Age Of Beneficiaries | 84 |
| Number Of Beneficiaries Age Less65 | 127 |
| Number Of Beneficiaries Age 65 to 74 | 320 |
| Number Of Beneficiaries Age 75 to 84 | 746 |
| Number Of Beneficiaries Age Greater 84 | 1385 |
| Number Of Female Beneficiaries | 1770 |
| Number Of Male Beneficiaries | 808 |
| Number Of Non Hispanic White Beneficiaries | 2423 |
| Number Of Black or African American Beneficiaries | 56 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 84 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 956 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1622 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 71 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 58 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 20 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 21 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.2774 |