| National Provider Identifier [NPI]: | 1285680538 |
| Last Name Of The Provider | SOPER |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2315 E HARMONY RD |
| Street Address 2 Of The Provider | SUITE 140 |
| City Of The Provider | FORT COLLINS |
| Zip Code Of The Provider | 805288620 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 3186 |
| Number Of Medicare Beneficiaries | 667 |
| Total Submitted Charge Amount | 446476.84 |
| Total Medicare Allowed Amount | 247971.32 |
| Total Medicare Payment Amount | 184076.9 |
| Total Medicare Standardized Payment Amount | 186037.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 893 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 92006 |
| Total Drug Medicare AllowedAmount | 50604.21 |
| Total Drug Medicare PaymentAmount | 38924.05 |
| Total Drug Medicare Standardized Payment Amount | 38924.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 2293 |
| Number Of Medicare Beneficiaries With Medical Services | 665 |
| Total Medical Submitted Charge Amount | 354470.84 |
| Total Medical Medicare Allowed Amount | 197367.11 |
| Total Medical Medicare Payment Amount | 145152.85 |
| Total Medical Medicare Standardized Payment Amount | 147113.93 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 303 |
| Number Of Beneficiaries Age 75 to 84 | 240 |
| Number Of Beneficiaries Age Greater 84 | 93 |
| Number Of Female Beneficiaries | 112 |
| Number Of Male Beneficiaries | 555 |
| Number Of Non Hispanic White Beneficiaries | 617 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 624 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0474 |