| National Provider Identifier [NPI]: | 1982688057 |
| Last Name Of The Provider | COPAS |
| First Name Of The Provider | BRYAN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | PA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 569 32 RD, UNIT 12 |
| Street Address 2 Of The Provider | MOUNTAIN PEAKS URGENT CARE |
| City Of The Provider | GRAND JUNCTION |
| Zip Code Of The Provider | 815046095 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 229 |
| Number Of Medicare Beneficiaries | 98 |
| Total Submitted Charge Amount | 37031.98 |
| Total Medicare Allowed Amount | 14736.16 |
| Total Medicare Payment Amount | 9820.8 |
| Total Medicare Standardized Payment Amount | 11949.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 259.98 |
| Total Drug Medicare AllowedAmount | 83.84 |
| Total Drug Medicare PaymentAmount | 70.46 |
| Total Drug Medicare Standardized Payment Amount | 70.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 205 |
| Number Of Medicare Beneficiaries With Medical Services | 98 |
| Total Medical Submitted Charge Amount | 36772 |
| Total Medical Medicare Allowed Amount | 14652.32 |
| Total Medical Medicare Payment Amount | 9750.34 |
| Total Medical Medicare Standardized Payment Amount | 11878.84 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 57 |
| Number Of Beneficiaries Age 75 to 84 | 22 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 60 |
| Number Of Male Beneficiaries | 38 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 11 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 34 |
| Percent Of With Ischemic Heart Disease | 12 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.7563 |