| National Provider Identifier [NPI]: | 1306033931 |
| Last Name Of The Provider | COLLETTI |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4580 S EASTERN AVE |
| Street Address 2 Of The Provider | #29 |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891196100 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 1210 |
| Number Of Medicare Beneficiaries | 280 |
| Total Submitted Charge Amount | 148743 |
| Total Medicare Allowed Amount | 112879.99 |
| Total Medicare Payment Amount | 74832.43 |
| Total Medicare Standardized Payment Amount | 79849.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 104 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 3608 |
| Total Drug Medicare AllowedAmount | 871.05 |
| Total Drug Medicare PaymentAmount | 649.76 |
| Total Drug Medicare Standardized Payment Amount | 649.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 6 |
| Number Of Medical Services | 1106 |
| Number Of Medicare Beneficiaries With Medical Services | 280 |
| Total Medical Submitted Charge Amount | 145135 |
| Total Medical Medicare Allowed Amount | 112008.94 |
| Total Medical Medicare Payment Amount | 74182.67 |
| Total Medical Medicare Standardized Payment Amount | 79199.44 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 140 |
| Number Of Beneficiaries Age 75 to 84 | 69 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 207 |
| Number Of Male Beneficiaries | 73 |
| Number Of Non Hispanic White Beneficiaries | 203 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 263 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1576 |