| National Provider Identifier [NPI]: | 1649207333 |
| Last Name Of The Provider | COPERTINO |
| First Name Of The Provider | LEONARD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 365 MONTAUK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW LONDON |
| Zip Code Of The Provider | 06320 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 129 |
| Number Of Services | 4917 |
| Number Of Medicare Beneficiaries | 2937 |
| Total Submitted Charge Amount | 532453 |
| Total Medicare Allowed Amount | 125121.1 |
| Total Medicare Payment Amount | 97339.6 |
| Total Medicare Standardized Payment Amount | 93614.58 |
| 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 | 129 |
| Number Of Medical Services | 4917 |
| Number Of Medicare Beneficiaries With Medical Services | 2937 |
| Total Medical Submitted Charge Amount | 532453 |
| Total Medical Medicare Allowed Amount | 125121.1 |
| Total Medical Medicare Payment Amount | 97339.6 |
| Total Medical Medicare Standardized Payment Amount | 93614.58 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 434 |
| Number Of Beneficiaries Age 65 to 74 | 1047 |
| Number Of Beneficiaries Age 75 to 84 | 886 |
| Number Of Beneficiaries Age Greater 84 | 570 |
| Number Of Female Beneficiaries | 1965 |
| Number Of Male Beneficiaries | 972 |
| Number Of Non Hispanic White Beneficiaries | 2537 |
| Number Of Black or African American Beneficiaries | 150 |
| Number Of AsianPacific Islander Beneficiaries | 44 |
| Number Of Hispanic Beneficiaries | 144 |
| Number Of American Indian Alaska Native Beneficiaries | 13 |
| Number Of Beneficiaries With Race Not Else where Classified | 49 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2062 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 875 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5453 |