| National Provider Identifier [NPI]: | 1386885382 |
| Last Name Of The Provider | SOTO |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3401 N BROAD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191405103 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 248 |
| Number Of Services | 3154 |
| Number Of Medicare Beneficiaries | 1766 |
| Total Submitted Charge Amount | 1013694.75 |
| Total Medicare Allowed Amount | 166234.12 |
| Total Medicare Payment Amount | 129361.75 |
| Total Medicare Standardized Payment Amount | 127511.85 |
| 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 | 248 |
| Number Of Medical Services | 3154 |
| Number Of Medicare Beneficiaries With Medical Services | 1766 |
| Total Medical Submitted Charge Amount | 1013694.75 |
| Total Medical Medicare Allowed Amount | 166234.12 |
| Total Medical Medicare Payment Amount | 129361.75 |
| Total Medical Medicare Standardized Payment Amount | 127511.85 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 376 |
| Number Of Beneficiaries Age 65 to 74 | 576 |
| Number Of Beneficiaries Age 75 to 84 | 462 |
| Number Of Beneficiaries Age Greater 84 | 352 |
| Number Of Female Beneficiaries | 965 |
| Number Of Male Beneficiaries | 801 |
| Number Of Non Hispanic White Beneficiaries | 877 |
| Number Of Black or African American Beneficiaries | 266 |
| Number Of AsianPacific Islander Beneficiaries | 178 |
| Number Of Hispanic Beneficiaries | 403 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 835 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 931 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.374 |