| National Provider Identifier [NPI]: | 1861587115 |
| Last Name Of The Provider | BAKOS |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5300 FAR HILLS AVE. |
| Street Address 2 Of The Provider | |
| City Of The Provider | DAYTON |
| Zip Code Of The Provider | 454292347 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 6385 |
| Number Of Medicare Beneficiaries | 1158 |
| Total Submitted Charge Amount | 569247 |
| Total Medicare Allowed Amount | 321831.73 |
| Total Medicare Payment Amount | 232226.17 |
| Total Medicare Standardized Payment Amount | 242126.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1240 |
| Number Of Medicare Beneficiaries With Drug Services | 102 |
| Total Drug Submitted ChargeAmount | 40015 |
| Total Drug Medicare AllowedAmount | 28405.29 |
| Total Drug Medicare PaymentAmount | 22164.57 |
| Total Drug Medicare Standardized Payment Amount | 22164.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 5145 |
| Number Of Medicare Beneficiaries With Medical Services | 1158 |
| Total Medical Submitted Charge Amount | 529232 |
| Total Medical Medicare Allowed Amount | 293426.44 |
| Total Medical Medicare Payment Amount | 210061.6 |
| Total Medical Medicare Standardized Payment Amount | 219962.24 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 635 |
| Number Of Beneficiaries Age 75 to 84 | 351 |
| Number Of Beneficiaries Age Greater 84 | 108 |
| Number Of Female Beneficiaries | 586 |
| Number Of Male Beneficiaries | 572 |
| Number Of Non Hispanic White Beneficiaries | 1097 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1105 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9104 |