| National Provider Identifier [NPI]: | 1295722429 |
| Last Name Of The Provider | COUP |
| First Name Of The Provider | GREGG |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7301 E FRONTAGE RD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MERRIAM |
| Zip Code Of The Provider | 662041632 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 882 |
| Number Of Medicare Beneficiaries | 297 |
| Total Submitted Charge Amount | 99442 |
| Total Medicare Allowed Amount | 55392.77 |
| Total Medicare Payment Amount | 40130.33 |
| Total Medicare Standardized Payment Amount | 43404 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 69 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 2578 |
| Total Drug Medicare AllowedAmount | 1918.5 |
| Total Drug Medicare PaymentAmount | 1868.81 |
| Total Drug Medicare Standardized Payment Amount | 1868.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 813 |
| Number Of Medicare Beneficiaries With Medical Services | 297 |
| Total Medical Submitted Charge Amount | 96864 |
| Total Medical Medicare Allowed Amount | 53474.27 |
| Total Medical Medicare Payment Amount | 38261.52 |
| Total Medical Medicare Standardized Payment Amount | 41535.19 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 120 |
| Number Of Beneficiaries Age 75 to 84 | 86 |
| Number Of Beneficiaries Age Greater 84 | 49 |
| Number Of Female Beneficiaries | 140 |
| Number Of Male Beneficiaries | 157 |
| Number Of Non Hispanic White Beneficiaries | 269 |
| Number Of Black or African American Beneficiaries | 15 |
| 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 | 264 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 33 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1002 |