| National Provider Identifier [NPI]: | 1316063423 |
| Last Name Of The Provider | COLLINS |
| First Name Of The Provider | WELDON |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3070 COLLEGE ST |
| Street Address 2 Of The Provider | SUITE 208 |
| City Of The Provider | BEAUMONT |
| Zip Code Of The Provider | 777014691 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 11872 |
| Number Of Medicare Beneficiaries | 1990 |
| Total Submitted Charge Amount | 1349830 |
| Total Medicare Allowed Amount | 584325.55 |
| Total Medicare Payment Amount | 415473.87 |
| Total Medicare Standardized Payment Amount | 441691.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 678 |
| Number Of Medicare Beneficiaries With Drug Services | 95 |
| Total Drug Submitted ChargeAmount | 40190 |
| Total Drug Medicare AllowedAmount | 2794.27 |
| Total Drug Medicare PaymentAmount | 2054.47 |
| Total Drug Medicare Standardized Payment Amount | 2054.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 11194 |
| Number Of Medicare Beneficiaries With Medical Services | 1990 |
| Total Medical Submitted Charge Amount | 1309640 |
| Total Medical Medicare Allowed Amount | 581531.28 |
| Total Medical Medicare Payment Amount | 413419.4 |
| Total Medical Medicare Standardized Payment Amount | 439637.3 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 787 |
| Number Of Beneficiaries Age 75 to 84 | 796 |
| Number Of Beneficiaries Age Greater 84 | 346 |
| Number Of Female Beneficiaries | 1047 |
| Number Of Male Beneficiaries | 943 |
| Number Of Non Hispanic White Beneficiaries | 1936 |
| Number Of Black or African American Beneficiaries | 29 |
| 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 | 1935 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 55 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0088 |