| National Provider Identifier [NPI]: | 1578768156 |
| Last Name Of The Provider | LOPER |
| First Name Of The Provider | TODD |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 MAR WALT DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WALTON BEACH |
| Zip Code Of The Provider | 325476708 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 274 |
| Number Of Services | 6470 |
| Number Of Medicare Beneficiaries | 3197 |
| Total Submitted Charge Amount | 874634 |
| Total Medicare Allowed Amount | 221903.5 |
| Total Medicare Payment Amount | 167935.89 |
| Total Medicare Standardized Payment Amount | 168160.33 |
| 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 | 274 |
| Number Of Medical Services | 6470 |
| Number Of Medicare Beneficiaries With Medical Services | 3197 |
| Total Medical Submitted Charge Amount | 874634 |
| Total Medical Medicare Allowed Amount | 221903.5 |
| Total Medical Medicare Payment Amount | 167935.89 |
| Total Medical Medicare Standardized Payment Amount | 168160.33 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 570 |
| Number Of Beneficiaries Age 65 to 74 | 992 |
| Number Of Beneficiaries Age 75 to 84 | 1087 |
| Number Of Beneficiaries Age Greater 84 | 548 |
| Number Of Female Beneficiaries | 1863 |
| Number Of Male Beneficiaries | 1334 |
| Number Of Non Hispanic White Beneficiaries | 2821 |
| Number Of Black or African American Beneficiaries | 255 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2278 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 919 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8275 |