| National Provider Identifier [NPI]: | 1598830978 |
| Last Name Of The Provider | COPELAND |
| First Name Of The Provider | JACK |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 725 JESSE JEWELL PKWY SE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GAINESVILLE |
| Zip Code Of The Provider | 305013834 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 976 |
| Number Of Medicare Beneficiaries | 492 |
| Total Submitted Charge Amount | 143042.5 |
| Total Medicare Allowed Amount | 78572.92 |
| Total Medicare Payment Amount | 60445.08 |
| Total Medicare Standardized Payment Amount | 63197.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 173 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 1684.5 |
| Total Drug Medicare AllowedAmount | 174.56 |
| Total Drug Medicare PaymentAmount | 152.7 |
| Total Drug Medicare Standardized Payment Amount | 152.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 803 |
| Number Of Medicare Beneficiaries With Medical Services | 490 |
| Total Medical Submitted Charge Amount | 141358 |
| Total Medical Medicare Allowed Amount | 78398.36 |
| Total Medical Medicare Payment Amount | 60292.38 |
| Total Medical Medicare Standardized Payment Amount | 63045.01 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 104 |
| Number Of Beneficiaries Age 65 to 74 | 155 |
| Number Of Beneficiaries Age 75 to 84 | 135 |
| Number Of Beneficiaries Age Greater 84 | 98 |
| Number Of Female Beneficiaries | 282 |
| Number Of Male Beneficiaries | 210 |
| Number Of Non Hispanic White Beneficiaries | 445 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 344 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 148 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.0512 |