| National Provider Identifier [NPI]: | 1295700433 |
| Last Name Of The Provider | COLLINS |
| First Name Of The Provider | BRANDI |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 336 N MAYO TRL |
| Street Address 2 Of The Provider | |
| City Of The Provider | PAINTSVILLE |
| Zip Code Of The Provider | 412401804 |
| 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 | 34 |
| Number Of Services | 5743 |
| Number Of Medicare Beneficiaries | 442 |
| Total Submitted Charge Amount | 273970.18 |
| Total Medicare Allowed Amount | 222496.11 |
| Total Medicare Payment Amount | 163399.51 |
| Total Medicare Standardized Payment Amount | 172519.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1025 |
| Number Of Medicare Beneficiaries With Drug Services | 263 |
| Total Drug Submitted ChargeAmount | 18170 |
| Total Drug Medicare AllowedAmount | 3450.83 |
| Total Drug Medicare PaymentAmount | 3063.58 |
| Total Drug Medicare Standardized Payment Amount | 3063.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 4718 |
| Number Of Medicare Beneficiaries With Medical Services | 442 |
| Total Medical Submitted Charge Amount | 255800.18 |
| Total Medical Medicare Allowed Amount | 219045.28 |
| Total Medical Medicare Payment Amount | 160335.93 |
| Total Medical Medicare Standardized Payment Amount | 169455.82 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 134 |
| Number Of Beneficiaries Age 65 to 74 | 177 |
| Number Of Beneficiaries Age 75 to 84 | 99 |
| Number Of Beneficiaries Age Greater 84 | 32 |
| Number Of Female Beneficiaries | 280 |
| Number Of Male Beneficiaries | 162 |
| 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 | 262 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 180 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2361 |