| National Provider Identifier [NPI]: | 1437379021 |
| Last Name Of The Provider | COLBERT |
| First Name Of The Provider | JAY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 21862 AL HWY 59 |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | ROBERTSDALE |
| Zip Code Of The Provider | 365676711 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 225 |
| Number Of Medicare Beneficiaries | 103 |
| Total Submitted Charge Amount | 38833 |
| Total Medicare Allowed Amount | 15398.37 |
| Total Medicare Payment Amount | 11307.08 |
| Total Medicare Standardized Payment Amount | 12453.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 23 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 666 |
| Total Drug Medicare AllowedAmount | 183.11 |
| Total Drug Medicare PaymentAmount | 165.89 |
| Total Drug Medicare Standardized Payment Amount | 165.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 202 |
| Number Of Medicare Beneficiaries With Medical Services | 103 |
| Total Medical Submitted Charge Amount | 38167 |
| Total Medical Medicare Allowed Amount | 15215.26 |
| Total Medical Medicare Payment Amount | 11141.19 |
| Total Medical Medicare Standardized Payment Amount | 12288.05 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 45 |
| Number Of Beneficiaries Age 65 to 74 | 30 |
| Number Of Beneficiaries Age 75 to 84 | 17 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 59 |
| Number Of Male Beneficiaries | 44 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 66 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0905 |