| National Provider Identifier [NPI]: | 1760477970 |
| Last Name Of The Provider | COLLINGWOOD |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4411 THE 25 WAY NE |
| Street Address 2 Of The Provider | SUITE 150 |
| City Of The Provider | ALBUQUERQUE |
| Zip Code Of The Provider | 871095857 |
| State Code Of The Provider | NM |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 150 |
| Number Of Services | 4882.5 |
| Number Of Medicare Beneficiaries | 3440 |
| Total Submitted Charge Amount | 633950.38 |
| Total Medicare Allowed Amount | 174720.73 |
| Total Medicare Payment Amount | 133458.87 |
| Total Medicare Standardized Payment Amount | 138917.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 404.5 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 698.88 |
| Total Drug Medicare AllowedAmount | 319.73 |
| Total Drug Medicare PaymentAmount | 234.96 |
| Total Drug Medicare Standardized Payment Amount | 234.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 146 |
| Number Of Medical Services | 4478 |
| Number Of Medicare Beneficiaries With Medical Services | 3440 |
| Total Medical Submitted Charge Amount | 633251.5 |
| Total Medical Medicare Allowed Amount | 174401 |
| Total Medical Medicare Payment Amount | 133223.91 |
| Total Medical Medicare Standardized Payment Amount | 138682.34 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 721 |
| Number Of Beneficiaries Age 65 to 74 | 1235 |
| Number Of Beneficiaries Age 75 to 84 | 1002 |
| Number Of Beneficiaries Age Greater 84 | 482 |
| Number Of Female Beneficiaries | 2070 |
| Number Of Male Beneficiaries | 1370 |
| Number Of Non Hispanic White Beneficiaries | 2147 |
| Number Of Black or African American Beneficiaries | 84 |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| Number Of Hispanic Beneficiaries | 1016 |
| Number Of American Indian Alaska Native Beneficiaries | 126 |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2431 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1009 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.4464 |