| National Provider Identifier [NPI]: | 1770599284 |
| Last Name Of The Provider | COOPER |
| First Name Of The Provider | MELISA |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MMS, PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1818 EAST 23RD AVE. |
| Street Address 2 Of The Provider | PINNACLE SPORTS MEDICINE & ORTHOPAEDICS PA |
| City Of The Provider | HUTHCINSON |
| Zip Code Of The Provider | 675021106 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 904 |
| Number Of Medicare Beneficiaries | 200 |
| Total Submitted Charge Amount | 53157 |
| Total Medicare Allowed Amount | 25953.6 |
| Total Medicare Payment Amount | 19812.81 |
| Total Medicare Standardized Payment Amount | 23428.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 261 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 6340 |
| Total Drug Medicare AllowedAmount | 4769.79 |
| Total Drug Medicare PaymentAmount | 3783.36 |
| Total Drug Medicare Standardized Payment Amount | 3783.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 643 |
| Number Of Medicare Beneficiaries With Medical Services | 200 |
| Total Medical Submitted Charge Amount | 46817 |
| Total Medical Medicare Allowed Amount | 21183.81 |
| Total Medical Medicare Payment Amount | 16029.45 |
| Total Medical Medicare Standardized Payment Amount | 19645.08 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 82 |
| Number Of Beneficiaries Age 75 to 84 | 50 |
| Number Of Beneficiaries Age Greater 84 | 34 |
| Number Of Female Beneficiaries | 131 |
| Number Of Male Beneficiaries | 69 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 166 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9642 |