| National Provider Identifier [NPI]: | 1710915210 |
| Last Name Of The Provider | CAPPER |
| First Name Of The Provider | STANLEY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9211 E 21ST ST N |
| Street Address 2 Of The Provider | |
| City Of The Provider | WICHITA |
| Zip Code Of The Provider | 672062968 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 5695 |
| Number Of Medicare Beneficiaries | 1338 |
| Total Submitted Charge Amount | 530819 |
| Total Medicare Allowed Amount | 277411.45 |
| Total Medicare Payment Amount | 192187.03 |
| Total Medicare Standardized Payment Amount | 203351.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 67 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 4388 |
| Total Drug Medicare AllowedAmount | 4324.98 |
| Total Drug Medicare PaymentAmount | 3232.14 |
| Total Drug Medicare Standardized Payment Amount | 3232.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 5628 |
| Number Of Medicare Beneficiaries With Medical Services | 1338 |
| Total Medical Submitted Charge Amount | 526431 |
| Total Medical Medicare Allowed Amount | 273086.47 |
| Total Medical Medicare Payment Amount | 188954.89 |
| Total Medical Medicare Standardized Payment Amount | 200119.34 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 481 |
| Number Of Beneficiaries Age 75 to 84 | 545 |
| Number Of Beneficiaries Age Greater 84 | 265 |
| Number Of Female Beneficiaries | 536 |
| Number Of Male Beneficiaries | 802 |
| Number Of Non Hispanic White Beneficiaries | 1283 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1275 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.964 |