National Provider Identifier [NPI]: |
1447366554 |
Last Name Of The Provider |
COOPER |
First Name Of The Provider |
LISA |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3990 JOHN R ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
482012018 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
69 |
Number Of Services |
310 |
Number Of Medicare Beneficiaries |
286 |
Total Submitted Charge Amount |
551369 |
Total Medicare Allowed Amount |
55460.47 |
Total Medicare Payment Amount |
42909.44 |
Total Medicare Standardized Payment Amount |
41904.39 |
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 |
69 |
Number Of Medical Services |
310 |
Number Of Medicare Beneficiaries With Medical Services |
286 |
Total Medical Submitted Charge Amount |
551369 |
Total Medical Medicare Allowed Amount |
55460.47 |
Total Medical Medicare Payment Amount |
42909.44 |
Total Medical Medicare Standardized Payment Amount |
41904.39 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
116 |
Number Of Beneficiaries Age 65 to 74 |
113 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
147 |
Number Of Male Beneficiaries |
139 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
181 |
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 |
149 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
137 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
3.1243 |