| National Provider Identifier [NPI]: | 1821000217 |
| Last Name Of The Provider | COLLINS |
| First Name Of The Provider | DEBORAH |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 435 MAXINE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MORTON |
| Zip Code Of The Provider | 615502498 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 727 |
| Number Of Medicare Beneficiaries | 245 |
| Total Submitted Charge Amount | 83809 |
| Total Medicare Allowed Amount | 34268.62 |
| Total Medicare Payment Amount | 23779.65 |
| Total Medicare Standardized Payment Amount | 29448.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 189 |
| Number Of Medicare Beneficiaries With Drug Services | 57 |
| Total Drug Submitted ChargeAmount | 4632 |
| Total Drug Medicare AllowedAmount | 2356.42 |
| Total Drug Medicare PaymentAmount | 2103.41 |
| Total Drug Medicare Standardized Payment Amount | 2103.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 538 |
| Number Of Medicare Beneficiaries With Medical Services | 245 |
| Total Medical Submitted Charge Amount | 79177 |
| Total Medical Medicare Allowed Amount | 31912.2 |
| Total Medical Medicare Payment Amount | 21676.24 |
| Total Medical Medicare Standardized Payment Amount | 27345.43 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 104 |
| Number Of Beneficiaries Age 75 to 84 | 70 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 148 |
| Number Of Male Beneficiaries | 97 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 203 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1103 |