| National Provider Identifier [NPI]: | 1114127974 |
| Last Name Of The Provider | KOPINSKI |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 132 ABIGAIL LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORT MATILDA |
| Zip Code Of The Provider | 168707153 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 2629 |
| Number Of Medicare Beneficiaries | 805 |
| Total Submitted Charge Amount | 1154428 |
| Total Medicare Allowed Amount | 174330.94 |
| Total Medicare Payment Amount | 129862.22 |
| Total Medicare Standardized Payment Amount | 133155.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 754 |
| Number Of Medicare Beneficiaries With Drug Services | 64 |
| Total Drug Submitted ChargeAmount | 26984 |
| Total Drug Medicare AllowedAmount | 9001.41 |
| Total Drug Medicare PaymentAmount | 7060.65 |
| Total Drug Medicare Standardized Payment Amount | 7060.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 1875 |
| Number Of Medicare Beneficiaries With Medical Services | 805 |
| Total Medical Submitted Charge Amount | 1127444 |
| Total Medical Medicare Allowed Amount | 165329.53 |
| Total Medical Medicare Payment Amount | 122801.57 |
| Total Medical Medicare Standardized Payment Amount | 126095.1 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 122 |
| Number Of Beneficiaries Age 65 to 74 | 303 |
| Number Of Beneficiaries Age 75 to 84 | 268 |
| Number Of Beneficiaries Age Greater 84 | 112 |
| Number Of Female Beneficiaries | 441 |
| Number Of Male Beneficiaries | 364 |
| Number Of Non Hispanic White Beneficiaries | 785 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 620 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 185 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6133 |