| National Provider Identifier [NPI]: | 1174525836 |
| Last Name Of The Provider | COLLINS |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 109 E MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WHITESBURG |
| Zip Code Of The Provider | 418587351 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 668 |
| Number Of Medicare Beneficiaries | 210 |
| Total Submitted Charge Amount | 59659 |
| Total Medicare Allowed Amount | 35683.39 |
| Total Medicare Payment Amount | 26409.33 |
| Total Medicare Standardized Payment Amount | 28283.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 69 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 1615 |
| Total Drug Medicare AllowedAmount | 218.57 |
| Total Drug Medicare PaymentAmount | 199.63 |
| Total Drug Medicare Standardized Payment Amount | 199.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 599 |
| Number Of Medicare Beneficiaries With Medical Services | 210 |
| Total Medical Submitted Charge Amount | 58044 |
| Total Medical Medicare Allowed Amount | 35464.82 |
| Total Medical Medicare Payment Amount | 26209.7 |
| Total Medical Medicare Standardized Payment Amount | 28084.1 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 81 |
| Number Of Beneficiaries Age 65 to 74 | 74 |
| Number Of Beneficiaries Age 75 to 84 | 40 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 97 |
| Number Of Male Beneficiaries | 113 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 109 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 101 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0757 |