| National Provider Identifier [NPI]: | 1306924923 |
| Last Name Of The Provider | CHO |
| First Name Of The Provider | ALBERT |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 620 W EDISON RD |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | MISHAWAKA |
| Zip Code Of The Provider | 465452784 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 154 |
| Number Of Services | 3888 |
| Number Of Medicare Beneficiaries | 2509 |
| Total Submitted Charge Amount | 639840.89 |
| Total Medicare Allowed Amount | 143547.45 |
| Total Medicare Payment Amount | 106421.74 |
| Total Medicare Standardized Payment Amount | 112618.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 327 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 1053.69 |
| Total Drug Medicare AllowedAmount | 1053.24 |
| Total Drug Medicare PaymentAmount | 825.74 |
| Total Drug Medicare Standardized Payment Amount | 825.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 149 |
| Number Of Medical Services | 3561 |
| Number Of Medicare Beneficiaries With Medical Services | 2509 |
| Total Medical Submitted Charge Amount | 638787.2 |
| Total Medical Medicare Allowed Amount | 142494.21 |
| Total Medical Medicare Payment Amount | 105596 |
| Total Medical Medicare Standardized Payment Amount | 111792.99 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 490 |
| Number Of Beneficiaries Age 65 to 74 | 842 |
| Number Of Beneficiaries Age 75 to 84 | 748 |
| Number Of Beneficiaries Age Greater 84 | 429 |
| Number Of Female Beneficiaries | 1463 |
| Number Of Male Beneficiaries | 1046 |
| Number Of Non Hispanic White Beneficiaries | 2242 |
| Number Of Black or African American Beneficiaries | 168 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 64 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1823 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 686 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6206 |