| National Provider Identifier [NPI]: | 1497961353 |
| Last Name Of The Provider | KOVIE |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6245 INKSTER ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GARDEN CITY |
| Zip Code Of The Provider | 481354001 |
| 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 | 162 |
| Number Of Services | 4886 |
| Number Of Medicare Beneficiaries | 1601 |
| Total Submitted Charge Amount | 496077 |
| Total Medicare Allowed Amount | 123529.58 |
| Total Medicare Payment Amount | 97298.41 |
| Total Medicare Standardized Payment Amount | 94990.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2170 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 3725 |
| Total Drug Medicare AllowedAmount | 1349.62 |
| Total Drug Medicare PaymentAmount | 1058.16 |
| Total Drug Medicare Standardized Payment Amount | 1058.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 160 |
| Number Of Medical Services | 2716 |
| Number Of Medicare Beneficiaries With Medical Services | 1601 |
| Total Medical Submitted Charge Amount | 492352 |
| Total Medical Medicare Allowed Amount | 122179.96 |
| Total Medical Medicare Payment Amount | 96240.25 |
| Total Medical Medicare Standardized Payment Amount | 93932 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 177 |
| Number Of Beneficiaries Age 65 to 74 | 684 |
| Number Of Beneficiaries Age 75 to 84 | 449 |
| Number Of Beneficiaries Age Greater 84 | 291 |
| Number Of Female Beneficiaries | 1099 |
| Number Of Male Beneficiaries | 502 |
| Number Of Non Hispanic White Beneficiaries | 1489 |
| Number Of Black or African American Beneficiaries | 53 |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1382 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 219 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5489 |