National Provider Identifier [NPI]: |
1710949623 |
Last Name Of The Provider |
COOPER |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3910 S DUPONT SQ |
Street Address 2 Of The Provider |
SUITE A |
City Of The Provider |
LOUISVILLE |
Zip Code Of The Provider |
402074615 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
4443 |
Number Of Medicare Beneficiaries |
483 |
Total Submitted Charge Amount |
362997 |
Total Medicare Allowed Amount |
310645.25 |
Total Medicare Payment Amount |
241856.04 |
Total Medicare Standardized Payment Amount |
254900.82 |
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 |
7 |
Number Of Medical Services |
4443 |
Number Of Medicare Beneficiaries With Medical Services |
483 |
Total Medical Submitted Charge Amount |
362997 |
Total Medical Medicare Allowed Amount |
310645.25 |
Total Medical Medicare Payment Amount |
241856.04 |
Total Medical Medicare Standardized Payment Amount |
254900.82 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
170 |
Number Of Beneficiaries Age 65 to 74 |
160 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
247 |
Number Of Male Beneficiaries |
236 |
Number Of Non Hispanic White Beneficiaries |
381 |
Number Of Black or African American Beneficiaries |
89 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
276 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
207 |
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
21 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
52 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
58 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
3.5235 |