| National Provider Identifier [NPI]: | 1619942950 |
| Last Name Of The Provider | COLLOTTA |
| First Name Of The Provider | CHRISTINE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 LAKE AVE N |
| Street Address 2 Of The Provider | |
| City Of The Provider | WORCESTER |
| Zip Code Of The Provider | 016550002 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 440 |
| Number Of Medicare Beneficiaries | 293 |
| Total Submitted Charge Amount | 81933 |
| Total Medicare Allowed Amount | 25233.91 |
| Total Medicare Payment Amount | 18637.22 |
| Total Medicare Standardized Payment Amount | 21374.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 676 |
| Total Drug Medicare AllowedAmount | 313.04 |
| Total Drug Medicare PaymentAmount | 306.8 |
| Total Drug Medicare Standardized Payment Amount | 306.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 414 |
| Number Of Medicare Beneficiaries With Medical Services | 293 |
| Total Medical Submitted Charge Amount | 81257 |
| Total Medical Medicare Allowed Amount | 24920.87 |
| Total Medical Medicare Payment Amount | 18330.42 |
| Total Medical Medicare Standardized Payment Amount | 21067.84 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 110 |
| Number Of Beneficiaries Age 75 to 84 | 76 |
| Number Of Beneficiaries Age Greater 84 | 52 |
| Number Of Female Beneficiaries | 162 |
| Number Of Male Beneficiaries | 131 |
| Number Of Non Hispanic White Beneficiaries | 269 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 229 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1443 |