| National Provider Identifier [NPI]: | 1255332672 |
| Last Name Of The Provider | COLOMB |
| First Name Of The Provider | KELLY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1214 SPRING ST |
| Street Address 2 Of The Provider | SUITE 2 |
| City Of The Provider | JEFFERSONVILLE |
| Zip Code Of The Provider | 471303704 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 171 |
| Number Of Services | 7001 |
| Number Of Medicare Beneficiaries | 3521 |
| Total Submitted Charge Amount | 655141 |
| Total Medicare Allowed Amount | 175510.4 |
| Total Medicare Payment Amount | 139367.78 |
| Total Medicare Standardized Payment Amount | 148264.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1000 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 1810 |
| Total Drug Medicare AllowedAmount | 415.68 |
| Total Drug Medicare PaymentAmount | 325.87 |
| Total Drug Medicare Standardized Payment Amount | 325.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 169 |
| Number Of Medical Services | 6001 |
| Number Of Medicare Beneficiaries With Medical Services | 3520 |
| Total Medical Submitted Charge Amount | 653331 |
| Total Medical Medicare Allowed Amount | 175094.72 |
| Total Medical Medicare Payment Amount | 139041.91 |
| Total Medical Medicare Standardized Payment Amount | 147938.38 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 712 |
| Number Of Beneficiaries Age 65 to 74 | 1349 |
| Number Of Beneficiaries Age 75 to 84 | 1010 |
| Number Of Beneficiaries Age Greater 84 | 450 |
| Number Of Female Beneficiaries | 2370 |
| Number Of Male Beneficiaries | 1151 |
| Number Of Non Hispanic White Beneficiaries | 3353 |
| Number Of Black or African American Beneficiaries | 105 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2594 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 927 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6129 |