| National Provider Identifier [NPI]: | 1972564664 |
| Last Name Of The Provider | COELLO-JEMMALI |
| First Name Of The Provider | ELENA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | PSYD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9729 S DIXIE HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | PINECREST |
| Zip Code Of The Provider | 331562806 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Clinical Psychologist |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 7 |
| Number Of Services | 641.5 |
| Number Of Medicare Beneficiaries | 247 |
| Total Submitted Charge Amount | 159545 |
| Total Medicare Allowed Amount | 66367.07 |
| Total Medicare Payment Amount | 52032.15 |
| Total Medicare Standardized Payment Amount | 49099.67 |
| 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 | 7 |
| Number Of Medical Services | 641.5 |
| Number Of Medicare Beneficiaries With Medical Services | 247 |
| Total Medical Submitted Charge Amount | 159545 |
| Total Medical Medicare Allowed Amount | 66367.07 |
| Total Medical Medicare Payment Amount | 52032.15 |
| Total Medical Medicare Standardized Payment Amount | 49099.67 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 64 |
| Number Of Beneficiaries Age 75 to 84 | 104 |
| Number Of Beneficiaries Age Greater 84 | 55 |
| Number Of Female Beneficiaries | 159 |
| Number Of Male Beneficiaries | 88 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 202 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 68 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 179 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 54 |
| Percent Of With Asthma | 22 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 68 |
| Percent Of With Diabetes | 62 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 71 |
| Percent Of With Osteoporosis | 34 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 18 |
| Percent Of With Stroke | 25 |
| Average HCC Risk Score Of Beneficiaries | 2.5795 |