| National Provider Identifier [NPI]: | 1508964891 |
| Last Name Of The Provider | CAPORUSSO |
| First Name Of The Provider | ANNETTE |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1200 OAKLEAF WAY |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | ALTOONA |
| Zip Code Of The Provider | 547202245 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 920 |
| Number Of Medicare Beneficiaries | 226 |
| Total Submitted Charge Amount | 290792 |
| Total Medicare Allowed Amount | 71311.16 |
| Total Medicare Payment Amount | 52904.77 |
| Total Medicare Standardized Payment Amount | 54120.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 53 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 106 |
| Total Drug Medicare AllowedAmount | 94.52 |
| Total Drug Medicare PaymentAmount | 68.19 |
| Total Drug Medicare Standardized Payment Amount | 68.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 867 |
| Number Of Medicare Beneficiaries With Medical Services | 226 |
| Total Medical Submitted Charge Amount | 290686 |
| Total Medical Medicare Allowed Amount | 71216.64 |
| Total Medical Medicare Payment Amount | 52836.58 |
| Total Medical Medicare Standardized Payment Amount | 54052.6 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 99 |
| Number Of Beneficiaries Age 75 to 84 | 47 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 152 |
| Number Of Male Beneficiaries | 74 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 155 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 71 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4713 |