| National Provider Identifier [NPI]: | 1164615829 |
| Last Name Of The Provider | KALLU |
| First Name Of The Provider | PREETI |
| 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 | 620 10TH STREET N. |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST. PETERSBURG |
| Zip Code Of The Provider | 337051407 |
| 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 | 22 |
| Number Of Services | 1058 |
| Number Of Medicare Beneficiaries | 250 |
| Total Submitted Charge Amount | 165164 |
| Total Medicare Allowed Amount | 95693.51 |
| Total Medicare Payment Amount | 67480.39 |
| Total Medicare Standardized Payment Amount | 68725.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 40 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 1788 |
| Total Drug Medicare AllowedAmount | 919.24 |
| Total Drug Medicare PaymentAmount | 885.6 |
| Total Drug Medicare Standardized Payment Amount | 885.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 1018 |
| Number Of Medicare Beneficiaries With Medical Services | 250 |
| Total Medical Submitted Charge Amount | 163376 |
| Total Medical Medicare Allowed Amount | 94774.27 |
| Total Medical Medicare Payment Amount | 66594.79 |
| Total Medical Medicare Standardized Payment Amount | 67839.53 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 118 |
| Number Of Beneficiaries Age 75 to 84 | 72 |
| Number Of Beneficiaries Age Greater 84 | 32 |
| Number Of Female Beneficiaries | 181 |
| Number Of Male Beneficiaries | 69 |
| Number Of Non Hispanic White Beneficiaries | 212 |
| 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 | 233 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9759 |