| National Provider Identifier [NPI]: | 1609997071 |
| Last Name Of The Provider | COLETTA |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20455 LORAIN RD |
| Street Address 2 Of The Provider | SECOND FLOOR |
| City Of The Provider | FAIRVIEW PARK |
| Zip Code Of The Provider | 441263494 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 1645 |
| Number Of Medicare Beneficiaries | 679 |
| Total Submitted Charge Amount | 281833 |
| Total Medicare Allowed Amount | 160849.47 |
| Total Medicare Payment Amount | 118437.14 |
| Total Medicare Standardized Payment Amount | 123310.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 44 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 2530 |
| Total Drug Medicare AllowedAmount | 2335.88 |
| Total Drug Medicare PaymentAmount | 1831.31 |
| Total Drug Medicare Standardized Payment Amount | 1831.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 1601 |
| Number Of Medicare Beneficiaries With Medical Services | 679 |
| Total Medical Submitted Charge Amount | 279303 |
| Total Medical Medicare Allowed Amount | 158513.59 |
| Total Medical Medicare Payment Amount | 116605.83 |
| Total Medical Medicare Standardized Payment Amount | 121479.18 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 245 |
| Number Of Beneficiaries Age 75 to 84 | 237 |
| Number Of Beneficiaries Age Greater 84 | 147 |
| Number Of Female Beneficiaries | 350 |
| Number Of Male Beneficiaries | 329 |
| Number Of Non Hispanic White Beneficiaries | 637 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 606 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 73 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 74 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6873 |