| National Provider Identifier [NPI]: | 1700077625 |
| Last Name Of The Provider | GERMAINE |
| First Name Of The Provider | PAULINE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 COOPER PLZ |
| Street Address 2 Of The Provider | COOPER UNIVERISTY RADIOLOGY |
| City Of The Provider | CAMDEN |
| Zip Code Of The Provider | 081031461 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 3553 |
| Number Of Medicare Beneficiaries | 2114 |
| Total Submitted Charge Amount | 467281.92 |
| Total Medicare Allowed Amount | 153656.8 |
| Total Medicare Payment Amount | 123926.36 |
| Total Medicare Standardized Payment Amount | 118723.05 |
| 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 | 109 |
| Number Of Medical Services | 3553 |
| Number Of Medicare Beneficiaries With Medical Services | 2114 |
| Total Medical Submitted Charge Amount | 467281.92 |
| Total Medical Medicare Allowed Amount | 153656.8 |
| Total Medical Medicare Payment Amount | 123926.36 |
| Total Medical Medicare Standardized Payment Amount | 118723.05 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 521 |
| Number Of Beneficiaries Age 65 to 74 | 846 |
| Number Of Beneficiaries Age 75 to 84 | 533 |
| Number Of Beneficiaries Age Greater 84 | 214 |
| Number Of Female Beneficiaries | 1507 |
| Number Of Male Beneficiaries | 607 |
| Number Of Non Hispanic White Beneficiaries | 1237 |
| Number Of Black or African American Beneficiaries | 471 |
| Number Of AsianPacific Islander Beneficiaries | 56 |
| Number Of Hispanic Beneficiaries | 324 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1416 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 698 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6056 |