| National Provider Identifier [NPI]: | 1053303149 |
| Last Name Of The Provider | CACCAMO |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 540 LINCOLN PARK BLVD |
| Street Address 2 Of The Provider | STE 130 |
| City Of The Provider | KETTERING |
| Zip Code Of The Provider | 454296401 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 142 |
| Number Of Services | 5756 |
| Number Of Medicare Beneficiaries | 4072 |
| Total Submitted Charge Amount | 491219 |
| Total Medicare Allowed Amount | 125443.32 |
| Total Medicare Payment Amount | 97148.55 |
| Total Medicare Standardized Payment Amount | 100225.35 |
| 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 | 142 |
| Number Of Medical Services | 5756 |
| Number Of Medicare Beneficiaries With Medical Services | 4072 |
| Total Medical Submitted Charge Amount | 491219 |
| Total Medical Medicare Allowed Amount | 125443.32 |
| Total Medical Medicare Payment Amount | 97148.55 |
| Total Medical Medicare Standardized Payment Amount | 100225.35 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 825 |
| Number Of Beneficiaries Age 65 to 74 | 1281 |
| Number Of Beneficiaries Age 75 to 84 | 1203 |
| Number Of Beneficiaries Age Greater 84 | 763 |
| Number Of Female Beneficiaries | 2548 |
| Number Of Male Beneficiaries | 1524 |
| Number Of Non Hispanic White Beneficiaries | 3717 |
| Number Of Black or African American Beneficiaries | 252 |
| Number Of AsianPacific Islander Beneficiaries | 28 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 47 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2960 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1112 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8718 |