| National Provider Identifier [NPI]: | 1386853935 |
| Last Name Of The Provider | COLINA |
| First Name Of The Provider | DEBORAH |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 18 SKYLARK DR APT 10 |
| Street Address 2 Of The Provider | |
| City Of The Provider | LARKSPUR |
| Zip Code Of The Provider | 949391248 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 1175 |
| Number Of Medicare Beneficiaries | 803 |
| Total Submitted Charge Amount | 668899 |
| Total Medicare Allowed Amount | 146150.89 |
| Total Medicare Payment Amount | 113179.87 |
| Total Medicare Standardized Payment Amount | 109860.27 |
| 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 | 57 |
| Number Of Medical Services | 1175 |
| Number Of Medicare Beneficiaries With Medical Services | 803 |
| Total Medical Submitted Charge Amount | 668899 |
| Total Medical Medicare Allowed Amount | 146150.89 |
| Total Medical Medicare Payment Amount | 113179.87 |
| Total Medical Medicare Standardized Payment Amount | 109860.27 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 220 |
| Number Of Beneficiaries Age 65 to 74 | 199 |
| Number Of Beneficiaries Age 75 to 84 | 182 |
| Number Of Beneficiaries Age Greater 84 | 202 |
| Number Of Female Beneficiaries | 450 |
| Number Of Male Beneficiaries | 353 |
| Number Of Non Hispanic White Beneficiaries | 591 |
| Number Of Black or African American Beneficiaries | 69 |
| Number Of AsianPacific Islander Beneficiaries | 41 |
| Number Of Hispanic Beneficiaries | 78 |
| Number Of American Indian Alaska Native Beneficiaries | 13 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 450 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 353 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9435 |