| National Provider Identifier [NPI]: | 1649303603 |
| Last Name Of The Provider | CHITHRIKI |
| First Name Of The Provider | MAMATA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8700 BEVERLY BLVD |
| Street Address 2 Of The Provider | ROOM M 335 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 90048 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 141 |
| Number Of Services | 7950 |
| Number Of Medicare Beneficiaries | 5293 |
| Total Submitted Charge Amount | 3513005.28 |
| Total Medicare Allowed Amount | 354304.93 |
| Total Medicare Payment Amount | 267895.72 |
| Total Medicare Standardized Payment Amount | 260561.48 |
| 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 | 141 |
| Number Of Medical Services | 7950 |
| Number Of Medicare Beneficiaries With Medical Services | 5293 |
| Total Medical Submitted Charge Amount | 3513005.28 |
| Total Medical Medicare Allowed Amount | 354304.93 |
| Total Medical Medicare Payment Amount | 267895.72 |
| Total Medical Medicare Standardized Payment Amount | 260561.48 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 717 |
| Number Of Beneficiaries Age 65 to 74 | 1985 |
| Number Of Beneficiaries Age 75 to 84 | 1521 |
| Number Of Beneficiaries Age Greater 84 | 1070 |
| Number Of Female Beneficiaries | 2780 |
| Number Of Male Beneficiaries | 2513 |
| Number Of Non Hispanic White Beneficiaries | 3566 |
| Number Of Black or African American Beneficiaries | 699 |
| Number Of AsianPacific Islander Beneficiaries | 389 |
| Number Of Hispanic Beneficiaries | 456 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3251 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2042 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.3327 |