| National Provider Identifier [NPI]: | 1477569812 |
| Last Name Of The Provider | KOEPKE |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 269 S CANDY LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | COTTONWOOD |
| Zip Code Of The Provider | 863264158 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 143 |
| Number Of Services | 4803 |
| Number Of Medicare Beneficiaries | 3060 |
| Total Submitted Charge Amount | 236225.74 |
| Total Medicare Allowed Amount | 108908.38 |
| Total Medicare Payment Amount | 82478.93 |
| Total Medicare Standardized Payment Amount | 83796.43 |
| 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 | 143 |
| Number Of Medical Services | 4803 |
| Number Of Medicare Beneficiaries With Medical Services | 3060 |
| Total Medical Submitted Charge Amount | 236225.74 |
| Total Medical Medicare Allowed Amount | 108908.38 |
| Total Medical Medicare Payment Amount | 82478.93 |
| Total Medical Medicare Standardized Payment Amount | 83796.43 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 236 |
| Number Of Beneficiaries Age 65 to 74 | 1358 |
| Number Of Beneficiaries Age 75 to 84 | 975 |
| Number Of Beneficiaries Age Greater 84 | 491 |
| Number Of Female Beneficiaries | 1901 |
| Number Of Male Beneficiaries | 1159 |
| Number Of Non Hispanic White Beneficiaries | 2854 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 119 |
| Number Of American Indian Alaska Native Beneficiaries | 35 |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2736 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 324 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1406 |