| National Provider Identifier [NPI]: | 1568458370 |
| Last Name Of The Provider | COLVIN |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20 W KALEY ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ORLANDO |
| Zip Code Of The Provider | 328062931 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 146 |
| Number Of Services | 3280 |
| Number Of Medicare Beneficiaries | 2380 |
| Total Submitted Charge Amount | 352517 |
| Total Medicare Allowed Amount | 99905.39 |
| Total Medicare Payment Amount | 72933.63 |
| Total Medicare Standardized Payment Amount | 73507.87 |
| 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 | 146 |
| Number Of Medical Services | 3280 |
| Number Of Medicare Beneficiaries With Medical Services | 2380 |
| Total Medical Submitted Charge Amount | 352517 |
| Total Medical Medicare Allowed Amount | 99905.39 |
| Total Medical Medicare Payment Amount | 72933.63 |
| Total Medical Medicare Standardized Payment Amount | 73507.87 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 484 |
| Number Of Beneficiaries Age 65 to 74 | 741 |
| Number Of Beneficiaries Age 75 to 84 | 747 |
| Number Of Beneficiaries Age Greater 84 | 408 |
| Number Of Female Beneficiaries | 1331 |
| Number Of Male Beneficiaries | 1049 |
| Number Of Non Hispanic White Beneficiaries | 1624 |
| Number Of Black or African American Beneficiaries | 415 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 259 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 42 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1625 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 755 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.3912 |