National Provider Identifier [NPI]: |
1437284189 |
Last Name Of The Provider |
COOPER |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3 MEDICAL PARK DR |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
BENTON |
Zip Code Of The Provider |
720153728 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
75 |
Number Of Services |
3390 |
Number Of Medicare Beneficiaries |
604 |
Total Submitted Charge Amount |
242628.12 |
Total Medicare Allowed Amount |
155572.15 |
Total Medicare Payment Amount |
106385.3 |
Total Medicare Standardized Payment Amount |
119292.9 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
15 |
Number Of Drug Services |
567 |
Number Of Medicare Beneficiaries With Drug Services |
289 |
Total Drug Submitted ChargeAmount |
12622.12 |
Total Drug Medicare AllowedAmount |
5148.13 |
Total Drug Medicare PaymentAmount |
4939.62 |
Total Drug Medicare Standardized Payment Amount |
4939.62 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
60 |
Number Of Medical Services |
2823 |
Number Of Medicare Beneficiaries With Medical Services |
603 |
Total Medical Submitted Charge Amount |
230006 |
Total Medical Medicare Allowed Amount |
150424.02 |
Total Medical Medicare Payment Amount |
101445.68 |
Total Medical Medicare Standardized Payment Amount |
114353.28 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
90 |
Number Of Beneficiaries Age 65 to 74 |
262 |
Number Of Beneficiaries Age 75 to 84 |
167 |
Number Of Beneficiaries Age Greater 84 |
85 |
Number Of Female Beneficiaries |
331 |
Number Of Male Beneficiaries |
273 |
Number Of Non Hispanic White Beneficiaries |
586 |
Number Of Black or African American Beneficiaries |
|
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 |
545 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
59 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
56 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
3 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0224 |