| National Provider Identifier [NPI]: | 1548282916 |
| Last Name Of The Provider | COLAVITO |
| First Name Of The Provider | STEFANIE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2776 CLEVELAND AVE |
| Street Address 2 Of The Provider | SUITE 8228 |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339015864 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 2086 |
| Number Of Medicare Beneficiaries | 843 |
| Total Submitted Charge Amount | 441810.14 |
| Total Medicare Allowed Amount | 226497.02 |
| Total Medicare Payment Amount | 176002.33 |
| Total Medicare Standardized Payment Amount | 168971.84 |
| 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 | 14 |
| Number Of Medical Services | 2086 |
| Number Of Medicare Beneficiaries With Medical Services | 843 |
| Total Medical Submitted Charge Amount | 441810.14 |
| Total Medical Medicare Allowed Amount | 226497.02 |
| Total Medical Medicare Payment Amount | 176002.33 |
| Total Medical Medicare Standardized Payment Amount | 168971.84 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 117 |
| Number Of Beneficiaries Age 65 to 74 | 252 |
| Number Of Beneficiaries Age 75 to 84 | 263 |
| Number Of Beneficiaries Age Greater 84 | 211 |
| Number Of Female Beneficiaries | 449 |
| Number Of Male Beneficiaries | 394 |
| Number Of Non Hispanic White Beneficiaries | 681 |
| Number Of Black or African American Beneficiaries | 53 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 92 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 582 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 261 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 42 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.0372 |