| National Provider Identifier [NPI]: | 1083798268 |
| Last Name Of The Provider | KOLBERG |
| First Name Of The Provider | HEIDI |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 255 W LANCASTER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PAOLI |
| Zip Code Of The Provider | 193011763 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 137 |
| Number Of Services | 4227 |
| Number Of Medicare Beneficiaries | 2466 |
| Total Submitted Charge Amount | 743036.23 |
| Total Medicare Allowed Amount | 169140.34 |
| Total Medicare Payment Amount | 134158.58 |
| Total Medicare Standardized Payment Amount | 129673.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 293 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 1742.23 |
| Total Drug Medicare AllowedAmount | 391.54 |
| Total Drug Medicare PaymentAmount | 306.94 |
| Total Drug Medicare Standardized Payment Amount | 306.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 135 |
| Number Of Medical Services | 3934 |
| Number Of Medicare Beneficiaries With Medical Services | 2466 |
| Total Medical Submitted Charge Amount | 741294 |
| Total Medical Medicare Allowed Amount | 168748.8 |
| Total Medical Medicare Payment Amount | 133851.64 |
| Total Medical Medicare Standardized Payment Amount | 129366.73 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 256 |
| Number Of Beneficiaries Age 65 to 74 | 1024 |
| Number Of Beneficiaries Age 75 to 84 | 717 |
| Number Of Beneficiaries Age Greater 84 | 469 |
| Number Of Female Beneficiaries | 1746 |
| Number Of Male Beneficiaries | 720 |
| Number Of Non Hispanic White Beneficiaries | 1882 |
| Number Of Black or African American Beneficiaries | 496 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2146 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 320 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6146 |