| National Provider Identifier [NPI]: | 1174511992 |
| Last Name Of The Provider | COLVIN |
| First Name Of The Provider | RACHEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 30 HATFIELD LN |
| Street Address 2 Of The Provider | SUITE 208 |
| City Of The Provider | GOSHEN |
| Zip Code Of The Provider | 109246766 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 3335 |
| Number Of Medicare Beneficiaries | 757 |
| Total Submitted Charge Amount | 459193.42 |
| Total Medicare Allowed Amount | 235870.31 |
| Total Medicare Payment Amount | 173764.09 |
| Total Medicare Standardized Payment Amount | 174779.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 276 |
| Number Of Medicare Beneficiaries With Drug Services | 63 |
| Total Drug Submitted ChargeAmount | 12418.4 |
| Total Drug Medicare AllowedAmount | 3268.97 |
| Total Drug Medicare PaymentAmount | 2612.08 |
| Total Drug Medicare Standardized Payment Amount | 2612.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 3059 |
| Number Of Medicare Beneficiaries With Medical Services | 757 |
| Total Medical Submitted Charge Amount | 446775.02 |
| Total Medical Medicare Allowed Amount | 232601.34 |
| Total Medical Medicare Payment Amount | 171152.01 |
| Total Medical Medicare Standardized Payment Amount | 172167.02 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 89 |
| Number Of Beneficiaries Age 65 to 74 | 287 |
| Number Of Beneficiaries Age 75 to 84 | 263 |
| Number Of Beneficiaries Age Greater 84 | 118 |
| Number Of Female Beneficiaries | 372 |
| Number Of Male Beneficiaries | 385 |
| Number Of Non Hispanic White Beneficiaries | 658 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 637 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 120 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 2.4584 |