| National Provider Identifier [NPI]: | 1376540500 |
| Last Name Of The Provider | COPPA |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6110 53RD AVE E |
| Street Address 2 Of The Provider | |
| City Of The Provider | BRADENTON |
| Zip Code Of The Provider | 342039707 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 150 |
| Number Of Services | 3926 |
| Number Of Medicare Beneficiaries | 511 |
| Total Submitted Charge Amount | 297279 |
| Total Medicare Allowed Amount | 136082.74 |
| Total Medicare Payment Amount | 96074.61 |
| Total Medicare Standardized Payment Amount | 97448.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 1384 |
| Number Of Medicare Beneficiaries With Drug Services | 99 |
| Total Drug Submitted ChargeAmount | 28171 |
| Total Drug Medicare AllowedAmount | 14344.55 |
| Total Drug Medicare PaymentAmount | 12060.1 |
| Total Drug Medicare Standardized Payment Amount | 12060.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 135 |
| Number Of Medical Services | 2542 |
| Number Of Medicare Beneficiaries With Medical Services | 511 |
| Total Medical Submitted Charge Amount | 269108 |
| Total Medical Medicare Allowed Amount | 121738.19 |
| Total Medical Medicare Payment Amount | 84014.51 |
| Total Medical Medicare Standardized Payment Amount | 85388.28 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 254 |
| Number Of Beneficiaries Age 75 to 84 | 176 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 280 |
| Number Of Male Beneficiaries | 231 |
| Number Of Non Hispanic White Beneficiaries | 477 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 483 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9112 |