| National Provider Identifier [NPI]: | 1700899820 |
| Last Name Of The Provider | COLLADO |
| First Name Of The Provider | AGUSTIN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3340 TAMIAMI TRL |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORT CHARLOTTE |
| Zip Code Of The Provider | 339528088 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 4621 |
| Number Of Medicare Beneficiaries | 2659 |
| Total Submitted Charge Amount | 79163.44 |
| Total Medicare Allowed Amount | 74780.68 |
| Total Medicare Payment Amount | 57691.32 |
| Total Medicare Standardized Payment Amount | 57570.27 |
| 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 | 18 |
| Number Of Medical Services | 4621 |
| Number Of Medicare Beneficiaries With Medical Services | 2659 |
| Total Medical Submitted Charge Amount | 79163.44 |
| Total Medical Medicare Allowed Amount | 74780.68 |
| Total Medical Medicare Payment Amount | 57691.32 |
| Total Medical Medicare Standardized Payment Amount | 57570.27 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 233 |
| Number Of Beneficiaries Age 65 to 74 | 817 |
| Number Of Beneficiaries Age 75 to 84 | 1008 |
| Number Of Beneficiaries Age Greater 84 | 601 |
| Number Of Female Beneficiaries | 1269 |
| Number Of Male Beneficiaries | 1390 |
| Number Of Non Hispanic White Beneficiaries | 2447 |
| Number Of Black or African American Beneficiaries | 91 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 84 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2204 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 455 |
| Percent Of With Atrial Fibrillation | 38 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 45 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.1027 |