| National Provider Identifier [NPI]: | 1003834540 |
| Last Name Of The Provider | COLBURN |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 83 WELLNESS WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | BENTON |
| Zip Code Of The Provider | 420257156 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 2094 |
| Number Of Medicare Beneficiaries | 379 |
| Total Submitted Charge Amount | 240631.4 |
| Total Medicare Allowed Amount | 143825.32 |
| Total Medicare Payment Amount | 99890.85 |
| Total Medicare Standardized Payment Amount | 110651.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 241 |
| Number Of Medicare Beneficiaries With Drug Services | 85 |
| Total Drug Submitted ChargeAmount | 4256.4 |
| Total Drug Medicare AllowedAmount | 1033.8 |
| Total Drug Medicare PaymentAmount | 922.89 |
| Total Drug Medicare Standardized Payment Amount | 922.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 1853 |
| Number Of Medicare Beneficiaries With Medical Services | 379 |
| Total Medical Submitted Charge Amount | 236375 |
| Total Medical Medicare Allowed Amount | 142791.52 |
| Total Medical Medicare Payment Amount | 98967.96 |
| Total Medical Medicare Standardized Payment Amount | 109728.54 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 73 |
| Number Of Beneficiaries Age 65 to 74 | 165 |
| Number Of Beneficiaries Age 75 to 84 | 102 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 146 |
| Number Of Male Beneficiaries | 233 |
| 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 | 332 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9432 |