| National Provider Identifier [NPI]: | 1255569786 |
| Last Name Of The Provider | JOHN |
| First Name Of The Provider | KATRINA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.B.B.CH. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 39000 BOB HOPE DR |
| Street Address 2 Of The Provider | EMERGENCY DEPARTMENT |
| City Of The Provider | RANCHO MIRAGE |
| Zip Code Of The Provider | 922703221 |
| 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 | 29 |
| Number Of Services | 918 |
| Number Of Medicare Beneficiaries | 823 |
| Total Submitted Charge Amount | 718031.1 |
| Total Medicare Allowed Amount | 144013.74 |
| Total Medicare Payment Amount | 109314.4 |
| Total Medicare Standardized Payment Amount | 109148.4 |
| 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 | 29 |
| Number Of Medical Services | 918 |
| Number Of Medicare Beneficiaries With Medical Services | 823 |
| Total Medical Submitted Charge Amount | 718031.1 |
| Total Medical Medicare Allowed Amount | 144013.74 |
| Total Medical Medicare Payment Amount | 109314.4 |
| Total Medical Medicare Standardized Payment Amount | 109148.4 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 72 |
| Number Of Beneficiaries Age 65 to 74 | 217 |
| Number Of Beneficiaries Age 75 to 84 | 285 |
| Number Of Beneficiaries Age Greater 84 | 249 |
| Number Of Female Beneficiaries | 429 |
| Number Of Male Beneficiaries | 394 |
| Number Of Non Hispanic White Beneficiaries | 719 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 82 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 694 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 129 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9036 |