| National Provider Identifier [NPI]: | 1720206790 |
| Last Name Of The Provider | COLBERT |
| First Name Of The Provider | CARMELITA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 801 N CASS AVE |
| Street Address 2 Of The Provider | STE 150 |
| City Of The Provider | WESTMONT |
| Zip Code Of The Provider | 605591162 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 1628 |
| Number Of Medicare Beneficiaries | 197 |
| Total Submitted Charge Amount | 135969 |
| Total Medicare Allowed Amount | 73685.43 |
| Total Medicare Payment Amount | 54910.6 |
| Total Medicare Standardized Payment Amount | 51414.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 828 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 11950 |
| Total Drug Medicare AllowedAmount | 5219.04 |
| Total Drug Medicare PaymentAmount | 4041.27 |
| Total Drug Medicare Standardized Payment Amount | 4041.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 800 |
| Number Of Medicare Beneficiaries With Medical Services | 197 |
| Total Medical Submitted Charge Amount | 124019 |
| Total Medical Medicare Allowed Amount | 68466.39 |
| Total Medical Medicare Payment Amount | 50869.33 |
| Total Medical Medicare Standardized Payment Amount | 47372.97 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 70 |
| Number Of Beneficiaries Age 75 to 84 | 49 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 161 |
| Number Of Male Beneficiaries | 36 |
| Number Of Non Hispanic White Beneficiaries | 90 |
| Number Of Black or African American Beneficiaries | 91 |
| 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 | 121 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 76 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.832 |