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Little is known about nonfatal firearm injuries in the United States, and national estimates based on emergency department samples may not be accurate. To describe the incidence and distribution of nonfatal firearm injuries and estimate case fatality ratios (CFRs) for firearm injuries by external cause of injury code within California overall and by race/ethnicity, including an assessment of trends over time and geographic variation within the state. This serial cross-sectional study used complete statewide data for firearm-related mortal