| National Provider Identifier [NPI]: | 1003820150 |
| Last Name Of The Provider | CUPP |
| First Name Of The Provider | MICHAEL |
| 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 | 105 N KEENE ST |
| Street Address 2 Of The Provider | STE 201 |
| City Of The Provider | COLUMBIA |
| Zip Code Of The Provider | 652018131 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 13638 |
| Number Of Medicare Beneficiaries | 1526 |
| Total Submitted Charge Amount | 1633685 |
| Total Medicare Allowed Amount | 466781.57 |
| Total Medicare Payment Amount | 352531.98 |
| Total Medicare Standardized Payment Amount | 371689.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 3995 |
| Number Of Medicare Beneficiaries With Drug Services | 104 |
| Total Drug Submitted ChargeAmount | 528153 |
| Total Drug Medicare AllowedAmount | 130360.46 |
| Total Drug Medicare PaymentAmount | 99628.72 |
| Total Drug Medicare Standardized Payment Amount | 99628.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 9643 |
| Number Of Medicare Beneficiaries With Medical Services | 1526 |
| Total Medical Submitted Charge Amount | 1105532 |
| Total Medical Medicare Allowed Amount | 336421.11 |
| Total Medical Medicare Payment Amount | 252903.26 |
| Total Medical Medicare Standardized Payment Amount | 272061.03 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 659 |
| Number Of Beneficiaries Age 75 to 84 | 621 |
| Number Of Beneficiaries Age Greater 84 | 189 |
| Number Of Female Beneficiaries | 169 |
| Number Of Male Beneficiaries | 1357 |
| Number Of Non Hispanic White Beneficiaries | 1466 |
| Number Of Black or African American Beneficiaries | 34 |
| 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 | 1485 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 32 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0847 |