| National Provider Identifier [NPI]: | 1417919150 |
| Last Name Of The Provider | COLLINS |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13855 E 14TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN LEANDRO |
| Zip Code Of The Provider | 945782611 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 1808 |
| Number Of Medicare Beneficiaries | 792 |
| Total Submitted Charge Amount | 360048 |
| Total Medicare Allowed Amount | 61280.85 |
| Total Medicare Payment Amount | 47667.91 |
| Total Medicare Standardized Payment Amount | 33541.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 1808 |
| Number Of Medicare Beneficiaries With Medical Services | 792 |
| Total Medical Submitted Charge Amount | 360048 |
| Total Medical Medicare Allowed Amount | 61280.85 |
| Total Medical Medicare Payment Amount | 47667.91 |
| Total Medical Medicare Standardized Payment Amount | 33541.79 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 126 |
| Number Of Beneficiaries Age 65 to 74 | 325 |
| Number Of Beneficiaries Age 75 to 84 | 249 |
| Number Of Beneficiaries Age Greater 84 | 92 |
| Number Of Female Beneficiaries | 409 |
| Number Of Male Beneficiaries | 383 |
| Number Of Non Hispanic White Beneficiaries | 365 |
| Number Of Black or African American Beneficiaries | 142 |
| Number Of AsianPacific Islander Beneficiaries | 134 |
| Number Of Hispanic Beneficiaries | 127 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 477 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 315 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.1853 |