| National Provider Identifier [NPI]: | 1720041023 |
| Last Name Of The Provider | LEPORE |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 57 PROSPECT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NANTUCKET |
| Zip Code Of The Provider | 025542799 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 131 |
| Number Of Services | 5004 |
| Number Of Medicare Beneficiaries | 741 |
| Total Submitted Charge Amount | 520026.82 |
| Total Medicare Allowed Amount | 308555.47 |
| Total Medicare Payment Amount | 227032.57 |
| Total Medicare Standardized Payment Amount | 221935.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 407 |
| Number Of Medicare Beneficiaries With Drug Services | 239 |
| Total Drug Submitted ChargeAmount | 7899 |
| Total Drug Medicare AllowedAmount | 4385.45 |
| Total Drug Medicare PaymentAmount | 4121.56 |
| Total Drug Medicare Standardized Payment Amount | 4121.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 122 |
| Number Of Medical Services | 4597 |
| Number Of Medicare Beneficiaries With Medical Services | 741 |
| Total Medical Submitted Charge Amount | 512127.82 |
| Total Medical Medicare Allowed Amount | 304170.02 |
| Total Medical Medicare Payment Amount | 222911.01 |
| Total Medical Medicare Standardized Payment Amount | 217814.41 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 348 |
| Number Of Beneficiaries Age 75 to 84 | 242 |
| Number Of Beneficiaries Age Greater 84 | 112 |
| Number Of Female Beneficiaries | 365 |
| Number Of Male Beneficiaries | 376 |
| Number Of Non Hispanic White Beneficiaries | 687 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 676 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 65 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9356 |