National Provider Identifier [NPI]: |
1942207634 |
Last Name Of The Provider |
COOPER |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2425 13TH ST NW |
Street Address 2 Of The Provider |
|
City Of The Provider |
CANTON |
Zip Code Of The Provider |
447083116 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
3913 |
Number Of Medicare Beneficiaries |
744 |
Total Submitted Charge Amount |
227816 |
Total Medicare Allowed Amount |
204992.95 |
Total Medicare Payment Amount |
145239.23 |
Total Medicare Standardized Payment Amount |
151196.12 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
727 |
Number Of Medicare Beneficiaries With Drug Services |
223 |
Total Drug Submitted ChargeAmount |
14896 |
Total Drug Medicare AllowedAmount |
13502.46 |
Total Drug Medicare PaymentAmount |
12033.62 |
Total Drug Medicare Standardized Payment Amount |
12033.62 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
39 |
Number Of Medical Services |
3186 |
Number Of Medicare Beneficiaries With Medical Services |
743 |
Total Medical Submitted Charge Amount |
212920 |
Total Medical Medicare Allowed Amount |
191490.49 |
Total Medical Medicare Payment Amount |
133205.61 |
Total Medical Medicare Standardized Payment Amount |
139162.5 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
261 |
Number Of Beneficiaries Age 75 to 84 |
270 |
Number Of Beneficiaries Age Greater 84 |
132 |
Number Of Female Beneficiaries |
410 |
Number Of Male Beneficiaries |
334 |
Number Of Non Hispanic White Beneficiaries |
683 |
Number Of Black or African American Beneficiaries |
40 |
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 |
643 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
101 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.3299 |