| National Provider Identifier [NPI]: | 1952367278 |
| Last Name Of The Provider | KOUTRAS |
| First Name Of The Provider | PAUL |
| 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 | 580 COURT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | KEENE |
| Zip Code Of The Provider | 034311715 |
| State Code Of The Provider | NH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 243 |
| Number Of Services | 10995 |
| Number Of Medicare Beneficiaries | 4727 |
| Total Submitted Charge Amount | 1497803 |
| Total Medicare Allowed Amount | 345845.35 |
| Total Medicare Payment Amount | 265091.85 |
| Total Medicare Standardized Payment Amount | 266091.65 |
| 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 | 243 |
| Number Of Medical Services | 10995 |
| Number Of Medicare Beneficiaries With Medical Services | 4727 |
| Total Medical Submitted Charge Amount | 1497803 |
| Total Medical Medicare Allowed Amount | 345845.35 |
| Total Medical Medicare Payment Amount | 265091.85 |
| Total Medical Medicare Standardized Payment Amount | 266091.65 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 834 |
| Number Of Beneficiaries Age 65 to 74 | 1826 |
| Number Of Beneficiaries Age 75 to 84 | 1349 |
| Number Of Beneficiaries Age Greater 84 | 718 |
| Number Of Female Beneficiaries | 2997 |
| Number Of Male Beneficiaries | 1730 |
| Number Of Non Hispanic White Beneficiaries | 4580 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 93 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3783 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 944 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1949 |