National Provider Identifier [NPI]: |
1518939297 |
Last Name Of The Provider |
COOPER |
First Name Of The Provider |
LAWRENCE |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
233 LEWIS ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921032122 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
811 |
Number Of Medicare Beneficiaries |
221 |
Total Submitted Charge Amount |
202300.78 |
Total Medicare Allowed Amount |
93462.73 |
Total Medicare Payment Amount |
65232.28 |
Total Medicare Standardized Payment Amount |
62764.76 |
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 |
32 |
Number Of Medical Services |
811 |
Number Of Medicare Beneficiaries With Medical Services |
221 |
Total Medical Submitted Charge Amount |
202300.78 |
Total Medical Medicare Allowed Amount |
93462.73 |
Total Medical Medicare Payment Amount |
65232.28 |
Total Medical Medicare Standardized Payment Amount |
62764.76 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
101 |
Number Of Beneficiaries Age 75 to 84 |
66 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
114 |
Number Of Male Beneficiaries |
107 |
Number Of Non Hispanic White Beneficiaries |
101 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
31 |
Number Of Hispanic Beneficiaries |
60 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
65 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
156 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5172 |