| National Provider Identifier [NPI]: | 1346208279 |
| Last Name Of The Provider | CHACKO |
| First Name Of The Provider | LEENA |
| 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 | 17320 RED OAK DR |
| Street Address 2 Of The Provider | SUITE 260 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770902633 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 3158 |
| Number Of Medicare Beneficiaries | 367 |
| Total Submitted Charge Amount | 1123324.63 |
| Total Medicare Allowed Amount | 305423.69 |
| Total Medicare Payment Amount | 237836.77 |
| Total Medicare Standardized Payment Amount | 239031.35 |
| 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 | 17 |
| Number Of Medical Services | 3158 |
| Number Of Medicare Beneficiaries With Medical Services | 367 |
| Total Medical Submitted Charge Amount | 1123324.63 |
| Total Medical Medicare Allowed Amount | 305423.69 |
| Total Medical Medicare Payment Amount | 237836.77 |
| Total Medical Medicare Standardized Payment Amount | 239031.35 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 84 |
| Number Of Beneficiaries Age 65 to 74 | 126 |
| Number Of Beneficiaries Age 75 to 84 | 95 |
| Number Of Beneficiaries Age Greater 84 | 62 |
| Number Of Female Beneficiaries | 230 |
| Number Of Male Beneficiaries | 137 |
| Number Of Non Hispanic White Beneficiaries | 223 |
| Number Of Black or African American Beneficiaries | 89 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 241 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 126 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 59 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 22 |
| Average HCC Risk Score Of Beneficiaries | 2.5646 |