| National Provider Identifier [NPI]: | 1770574212 |
| Last Name Of The Provider | CAPITO |
| First Name Of The Provider | CHARLES |
| 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 | 703 COLLIERS WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEIRTON |
| Zip Code Of The Provider | 260625016 |
| State Code Of The Provider | WV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 3206 |
| Number Of Medicare Beneficiaries | 508 |
| Total Submitted Charge Amount | 563386.5 |
| Total Medicare Allowed Amount | 207200.63 |
| Total Medicare Payment Amount | 155902.4 |
| Total Medicare Standardized Payment Amount | 166130.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1231 |
| Number Of Medicare Beneficiaries With Drug Services | 250 |
| Total Drug Submitted ChargeAmount | 48120 |
| Total Drug Medicare AllowedAmount | 11564.03 |
| Total Drug Medicare PaymentAmount | 8832.06 |
| Total Drug Medicare Standardized Payment Amount | 8832.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 97 |
| Number Of Medical Services | 1975 |
| Number Of Medicare Beneficiaries With Medical Services | 508 |
| Total Medical Submitted Charge Amount | 515266.5 |
| Total Medical Medicare Allowed Amount | 195636.6 |
| Total Medical Medicare Payment Amount | 147070.34 |
| Total Medical Medicare Standardized Payment Amount | 157298.05 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 198 |
| Number Of Beneficiaries Age 75 to 84 | 150 |
| Number Of Beneficiaries Age Greater 84 | 94 |
| Number Of Female Beneficiaries | 322 |
| Number Of Male Beneficiaries | 186 |
| Number Of Non Hispanic White Beneficiaries | 489 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 419 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 89 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 70 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.1317 |