| National Provider Identifier [NPI]: | 1922167303 |
| Last Name Of The Provider | CHACKO |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D., PH.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 655 N WOODLAWN |
| Street Address 2 Of The Provider | |
| City Of The Provider | WICHITA |
| Zip Code Of The Provider | 67208 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 52246 |
| Number Of Medicare Beneficiaries | 2148 |
| Total Submitted Charge Amount | 5600625 |
| Total Medicare Allowed Amount | 2076097.93 |
| Total Medicare Payment Amount | 1561398.23 |
| Total Medicare Standardized Payment Amount | 1645310.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 33527 |
| Number Of Medicare Beneficiaries With Drug Services | 182 |
| Total Drug Submitted ChargeAmount | 506030 |
| Total Drug Medicare AllowedAmount | 463806.8 |
| Total Drug Medicare PaymentAmount | 362731.55 |
| Total Drug Medicare Standardized Payment Amount | 362731.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 18719 |
| Number Of Medicare Beneficiaries With Medical Services | 2148 |
| Total Medical Submitted Charge Amount | 5094595 |
| Total Medical Medicare Allowed Amount | 1612291.13 |
| Total Medical Medicare Payment Amount | 1198666.68 |
| Total Medical Medicare Standardized Payment Amount | 1282579.1 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 106 |
| Number Of Beneficiaries Age 65 to 74 | 617 |
| Number Of Beneficiaries Age 75 to 84 | 815 |
| Number Of Beneficiaries Age Greater 84 | 610 |
| Number Of Female Beneficiaries | 1292 |
| Number Of Male Beneficiaries | 856 |
| Number Of Non Hispanic White Beneficiaries | 2023 |
| Number Of Black or African American Beneficiaries | 40 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1973 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 175 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2663 |