| National Provider Identifier [NPI]: | 1447414602 |
| Last Name Of The Provider | KOLLI |
| First Name Of The Provider | SMITA |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 496 LYNNFIELD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LYNN |
| Zip Code Of The Provider | 019041423 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 1440 |
| Number Of Medicare Beneficiaries | 773 |
| Total Submitted Charge Amount | 412084 |
| Total Medicare Allowed Amount | 120340.37 |
| Total Medicare Payment Amount | 85282.71 |
| Total Medicare Standardized Payment Amount | 83781.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 56 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 419 |
| Total Drug Medicare AllowedAmount | 129.29 |
| Total Drug Medicare PaymentAmount | 117.67 |
| Total Drug Medicare Standardized Payment Amount | 117.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 1384 |
| Number Of Medicare Beneficiaries With Medical Services | 773 |
| Total Medical Submitted Charge Amount | 411665 |
| Total Medical Medicare Allowed Amount | 120211.08 |
| Total Medical Medicare Payment Amount | 85165.04 |
| Total Medical Medicare Standardized Payment Amount | 83663.52 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 126 |
| Number Of Beneficiaries Age 65 to 74 | 252 |
| Number Of Beneficiaries Age 75 to 84 | 213 |
| Number Of Beneficiaries Age Greater 84 | 182 |
| Number Of Female Beneficiaries | 481 |
| Number Of Male Beneficiaries | 292 |
| Number Of Non Hispanic White Beneficiaries | 699 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 564 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 209 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3492 |