| National Provider Identifier [NPI]: | 1457392581 |
| Last Name Of The Provider | CAPUTO |
| First Name Of The Provider | LARRY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2301 S BROAD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191483542 |
| 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 | 122 |
| Number Of Services | 6746 |
| Number Of Medicare Beneficiaries | 3516 |
| Total Submitted Charge Amount | 441135 |
| Total Medicare Allowed Amount | 141271.62 |
| Total Medicare Payment Amount | 107123.29 |
| Total Medicare Standardized Payment Amount | 101791.99 |
| 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 | 122 |
| Number Of Medical Services | 6746 |
| Number Of Medicare Beneficiaries With Medical Services | 3516 |
| Total Medical Submitted Charge Amount | 441135 |
| Total Medical Medicare Allowed Amount | 141271.62 |
| Total Medical Medicare Payment Amount | 107123.29 |
| Total Medical Medicare Standardized Payment Amount | 101791.99 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 768 |
| Number Of Beneficiaries Age 65 to 74 | 1347 |
| Number Of Beneficiaries Age 75 to 84 | 825 |
| Number Of Beneficiaries Age Greater 84 | 576 |
| Number Of Female Beneficiaries | 2105 |
| Number Of Male Beneficiaries | 1411 |
| Number Of Non Hispanic White Beneficiaries | 2518 |
| Number Of Black or African American Beneficiaries | 412 |
| Number Of AsianPacific Islander Beneficiaries | 119 |
| Number Of Hispanic Beneficiaries | 406 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2301 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1215 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5968 |