| National Provider Identifier [NPI]: | 1619190790 |
| Last Name Of The Provider | CHAKKO |
| First Name Of The Provider | MATHEW |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 16001 W 9 MILE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTHFIELD |
| Zip Code Of The Provider | 480754818 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 189 |
| Number Of Services | 6098 |
| Number Of Medicare Beneficiaries | 3815 |
| Total Submitted Charge Amount | 633339.85 |
| Total Medicare Allowed Amount | 237539.69 |
| Total Medicare Payment Amount | 178824.63 |
| Total Medicare Standardized Payment Amount | 175293.63 |
| 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 | 189 |
| Number Of Medical Services | 6098 |
| Number Of Medicare Beneficiaries With Medical Services | 3815 |
| Total Medical Submitted Charge Amount | 633339.85 |
| Total Medical Medicare Allowed Amount | 237539.69 |
| Total Medical Medicare Payment Amount | 178824.63 |
| Total Medical Medicare Standardized Payment Amount | 175293.63 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 796 |
| Number Of Beneficiaries Age 65 to 74 | 1229 |
| Number Of Beneficiaries Age 75 to 84 | 1064 |
| Number Of Beneficiaries Age Greater 84 | 726 |
| Number Of Female Beneficiaries | 2390 |
| Number Of Male Beneficiaries | 1425 |
| Number Of Non Hispanic White Beneficiaries | 2118 |
| Number Of Black or African American Beneficiaries | 1571 |
| Number Of AsianPacific Islander Beneficiaries | 46 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 52 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2746 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1069 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 2.2188 |