| National Provider Identifier [NPI]: | 1598790776 |
| Last Name Of The Provider | HOLLIS |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2109 GREEN VALLEY RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW ALBANY |
| Zip Code Of The Provider | 47150 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 71 |
| Number Of Services | 4781 |
| Number Of Medicare Beneficiaries | 1522 |
| Total Submitted Charge Amount | 381540 |
| Total Medicare Allowed Amount | 213788.32 |
| Total Medicare Payment Amount | 155009.87 |
| Total Medicare Standardized Payment Amount | 165458.45 |
| 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 | 71 |
| Number Of Medical Services | 4781 |
| Number Of Medicare Beneficiaries With Medical Services | 1522 |
| Total Medical Submitted Charge Amount | 381540 |
| Total Medical Medicare Allowed Amount | 213788.32 |
| Total Medical Medicare Payment Amount | 155009.87 |
| Total Medical Medicare Standardized Payment Amount | 165458.45 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 232 |
| Number Of Beneficiaries Age 65 to 74 | 573 |
| Number Of Beneficiaries Age 75 to 84 | 491 |
| Number Of Beneficiaries Age Greater 84 | 226 |
| Number Of Female Beneficiaries | 776 |
| Number Of Male Beneficiaries | 746 |
| Number Of Non Hispanic White Beneficiaries | 1457 |
| Number Of Black or African American Beneficiaries | 39 |
| 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 | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1192 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 330 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7821 |