| National Provider Identifier [NPI]: | 1467433573 |
| Last Name Of The Provider | COOPER |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2704 N OAK ST |
| Street Address 2 Of The Provider | BUILDING E |
| City Of The Provider | VALDOSTA |
| Zip Code Of The Provider | 316021744 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 150 |
| Number Of Services | 11999 |
| Number Of Medicare Beneficiaries | 5505 |
| Total Submitted Charge Amount | 968858.5 |
| Total Medicare Allowed Amount | 280804.13 |
| Total Medicare Payment Amount | 215054.26 |
| Total Medicare Standardized Payment Amount | 224276.31 |
| 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 | 150 |
| Number Of Medical Services | 11999 |
| Number Of Medicare Beneficiaries With Medical Services | 5505 |
| Total Medical Submitted Charge Amount | 968858.5 |
| Total Medical Medicare Allowed Amount | 280804.13 |
| Total Medical Medicare Payment Amount | 215054.26 |
| Total Medical Medicare Standardized Payment Amount | 224276.31 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1131 |
| Number Of Beneficiaries Age 65 to 74 | 2238 |
| Number Of Beneficiaries Age 75 to 84 | 1517 |
| Number Of Beneficiaries Age Greater 84 | 619 |
| Number Of Female Beneficiaries | 3446 |
| Number Of Male Beneficiaries | 2059 |
| Number Of Non Hispanic White Beneficiaries | 3917 |
| Number Of Black or African American Beneficiaries | 1437 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 72 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 49 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3881 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1624 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5239 |