| National Provider Identifier [NPI]: | 1679501225 |
| Last Name Of The Provider | KOLLI |
| First Name Of The Provider | SHALINI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6901 SNIDER PLZ |
| Street Address 2 Of The Provider | SUITE 130 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752055648 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 2129 |
| Number Of Medicare Beneficiaries | 528 |
| Total Submitted Charge Amount | 555784.56 |
| Total Medicare Allowed Amount | 221372.92 |
| Total Medicare Payment Amount | 173044.49 |
| Total Medicare Standardized Payment Amount | 172876.28 |
| 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 | 2129 |
| Number Of Medicare Beneficiaries With Medical Services | 528 |
| Total Medical Submitted Charge Amount | 555784.56 |
| Total Medical Medicare Allowed Amount | 221372.92 |
| Total Medical Medicare Payment Amount | 173044.49 |
| Total Medical Medicare Standardized Payment Amount | 172876.28 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 79 |
| Number Of Beneficiaries Age 65 to 74 | 151 |
| Number Of Beneficiaries Age 75 to 84 | 174 |
| Number Of Beneficiaries Age Greater 84 | 124 |
| Number Of Female Beneficiaries | 315 |
| Number Of Male Beneficiaries | 213 |
| Number Of Non Hispanic White Beneficiaries | 348 |
| Number Of Black or African American Beneficiaries | 105 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 61 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 383 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 145 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 61 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.5977 |