| National Provider Identifier [NPI]: | 1174734735 |
| Last Name Of The Provider | COLALUCE |
| First Name Of The Provider | MARC |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5760 10TH AVE N |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST PETERSBURG |
| Zip Code Of The Provider | 337106432 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 3397 |
| Number Of Medicare Beneficiaries | 687 |
| Total Submitted Charge Amount | 302198.66 |
| Total Medicare Allowed Amount | 221851.51 |
| Total Medicare Payment Amount | 169475.79 |
| Total Medicare Standardized Payment Amount | 169800.5 |
| 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 | 45 |
| Number Of Medical Services | 3397 |
| Number Of Medicare Beneficiaries With Medical Services | 687 |
| Total Medical Submitted Charge Amount | 302198.66 |
| Total Medical Medicare Allowed Amount | 221851.51 |
| Total Medical Medicare Payment Amount | 169475.79 |
| Total Medical Medicare Standardized Payment Amount | 169800.5 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 83 |
| Number Of Beneficiaries Age 65 to 74 | 120 |
| Number Of Beneficiaries Age 75 to 84 | 229 |
| Number Of Beneficiaries Age Greater 84 | 255 |
| Number Of Female Beneficiaries | 440 |
| Number Of Male Beneficiaries | 247 |
| Number Of Non Hispanic White Beneficiaries | 620 |
| Number Of Black or African American Beneficiaries | 40 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 567 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 120 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5227 |