| National Provider Identifier [NPI]: | 1871569293 |
| Last Name Of The Provider | KUPETZ |
| First Name Of The Provider | IRA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10301 GATEWAY BLVD W |
| Street Address 2 Of The Provider | |
| City Of The Provider | EL PASO |
| Zip Code Of The Provider | 799257701 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 179 |
| Number Of Services | 6514 |
| Number Of Medicare Beneficiaries | 3460 |
| Total Submitted Charge Amount | 595811 |
| Total Medicare Allowed Amount | 124762.35 |
| Total Medicare Payment Amount | 97120.09 |
| Total Medicare Standardized Payment Amount | 101648.83 |
| 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 | 179 |
| Number Of Medical Services | 6514 |
| Number Of Medicare Beneficiaries With Medical Services | 3460 |
| Total Medical Submitted Charge Amount | 595811 |
| Total Medical Medicare Allowed Amount | 124762.35 |
| Total Medical Medicare Payment Amount | 97120.09 |
| Total Medical Medicare Standardized Payment Amount | 101648.83 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 753 |
| Number Of Beneficiaries Age 65 to 74 | 1084 |
| Number Of Beneficiaries Age 75 to 84 | 1021 |
| Number Of Beneficiaries Age Greater 84 | 602 |
| Number Of Female Beneficiaries | 2258 |
| Number Of Male Beneficiaries | 1202 |
| Number Of Non Hispanic White Beneficiaries | 822 |
| Number Of Black or African American Beneficiaries | 88 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 2501 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1680 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1780 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.34 |