| National Provider Identifier [NPI]: | 1770516197 |
| Last Name Of The Provider | KOPLYAY |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1024 LEMAY AVENUE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT COLLINS |
| Zip Code Of The Provider | 80524 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 191 |
| Number Of Services | 3832 |
| Number Of Medicare Beneficiaries | 2676 |
| Total Submitted Charge Amount | 431456 |
| Total Medicare Allowed Amount | 118818.16 |
| Total Medicare Payment Amount | 88555.14 |
| Total Medicare Standardized Payment Amount | 89798.4 |
| 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 | 191 |
| Number Of Medical Services | 3832 |
| Number Of Medicare Beneficiaries With Medical Services | 2676 |
| Total Medical Submitted Charge Amount | 431456 |
| Total Medical Medicare Allowed Amount | 118818.16 |
| Total Medical Medicare Payment Amount | 88555.14 |
| Total Medical Medicare Standardized Payment Amount | 89798.4 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 403 |
| Number Of Beneficiaries Age 65 to 74 | 1057 |
| Number Of Beneficiaries Age 75 to 84 | 770 |
| Number Of Beneficiaries Age Greater 84 | 446 |
| Number Of Female Beneficiaries | 1694 |
| Number Of Male Beneficiaries | 982 |
| Number Of Non Hispanic White Beneficiaries | 2405 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 204 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2156 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 520 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3482 |