| National Provider Identifier [NPI]: | 1225019813 |
| Last Name Of The Provider | LABUS |
| First Name Of The Provider | THEODORE |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5901 TECHNOLOGY CENTER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462786013 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 196 |
| Number Of Services | 9014 |
| Number Of Medicare Beneficiaries | 4290 |
| Total Submitted Charge Amount | 816676 |
| Total Medicare Allowed Amount | 280401.36 |
| Total Medicare Payment Amount | 222039.8 |
| Total Medicare Standardized Payment Amount | 232084.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2935 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 1667 |
| Total Drug Medicare AllowedAmount | 586.1 |
| Total Drug Medicare PaymentAmount | 459.44 |
| Total Drug Medicare Standardized Payment Amount | 459.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 194 |
| Number Of Medical Services | 6079 |
| Number Of Medicare Beneficiaries With Medical Services | 4290 |
| Total Medical Submitted Charge Amount | 815009 |
| Total Medical Medicare Allowed Amount | 279815.26 |
| Total Medical Medicare Payment Amount | 221580.36 |
| Total Medical Medicare Standardized Payment Amount | 231625.18 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 689 |
| Number Of Beneficiaries Age 65 to 74 | 1745 |
| Number Of Beneficiaries Age 75 to 84 | 1235 |
| Number Of Beneficiaries Age Greater 84 | 621 |
| Number Of Female Beneficiaries | 2805 |
| Number Of Male Beneficiaries | 1485 |
| Number Of Non Hispanic White Beneficiaries | 3993 |
| Number Of Black or African American Beneficiaries | 214 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3353 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 937 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5064 |