| National Provider Identifier [NPI]: | 1275597163 |
| Last Name Of The Provider | COOPER |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 544 N GLENDALE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GLENDALE |
| Zip Code Of The Provider | 912063311 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 1212 |
| Number Of Medicare Beneficiaries | 536 |
| Total Submitted Charge Amount | 108711.81 |
| Total Medicare Allowed Amount | 78064.65 |
| Total Medicare Payment Amount | 57859.49 |
| Total Medicare Standardized Payment Amount | 52919.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 127 |
| Number Of Medicare Beneficiaries With Drug Services | 88 |
| Total Drug Submitted ChargeAmount | 2636.05 |
| Total Drug Medicare AllowedAmount | 1072.38 |
| Total Drug Medicare PaymentAmount | 869.63 |
| Total Drug Medicare Standardized Payment Amount | 869.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 1085 |
| Number Of Medicare Beneficiaries With Medical Services | 535 |
| Total Medical Submitted Charge Amount | 106075.76 |
| Total Medical Medicare Allowed Amount | 76992.27 |
| Total Medical Medicare Payment Amount | 56989.86 |
| Total Medical Medicare Standardized Payment Amount | 52050.21 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 239 |
| Number Of Beneficiaries Age 75 to 84 | 177 |
| Number Of Beneficiaries Age Greater 84 | 69 |
| Number Of Female Beneficiaries | 371 |
| Number Of Male Beneficiaries | 165 |
| Number Of Non Hispanic White Beneficiaries | 423 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | 57 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 368 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 168 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.045 |