| National Provider Identifier [NPI]: | 1720028830 |
| Last Name Of The Provider | COOPER |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 435 PHALEN BLVD |
| Street Address 2 Of The Provider | HEALTHPARTNERS SPECIALITY CENTER 435 |
| City Of The Provider | ST. PAUL |
| Zip Code Of The Provider | 551305302 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 355 |
| Number Of Medicare Beneficiaries | 70 |
| Total Submitted Charge Amount | 132527.6 |
| Total Medicare Allowed Amount | 39700 |
| Total Medicare Payment Amount | 29926.32 |
| Total Medicare Standardized Payment Amount | 31242.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 94 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 10970 |
| Total Drug Medicare AllowedAmount | 4322.42 |
| Total Drug Medicare PaymentAmount | 3020.25 |
| Total Drug Medicare Standardized Payment Amount | 3020.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 261 |
| Number Of Medicare Beneficiaries With Medical Services | 70 |
| Total Medical Submitted Charge Amount | 121557.6 |
| Total Medical Medicare Allowed Amount | 35377.58 |
| Total Medical Medicare Payment Amount | 26906.07 |
| Total Medical Medicare Standardized Payment Amount | 28222.18 |
| Average Age Of Beneficiaries | 58 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 31 |
| Number Of Male Beneficiaries | 39 |
| Number Of Non Hispanic White Beneficiaries | 44 |
| Number Of Black or African American Beneficiaries | |
| 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 | 29 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 70 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0706 |