National Provider Identifier [NPI]: |
1215917760 |
Last Name Of The Provider |
COOPER |
First Name Of The Provider |
SCOTT |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2300 HAGGERTY RD |
Street Address 2 Of The Provider |
SUITE 2120 |
City Of The Provider |
WEST BLOOMFIELD |
Zip Code Of The Provider |
483232184 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
769 |
Number Of Medicare Beneficiaries |
205 |
Total Submitted Charge Amount |
159066.5 |
Total Medicare Allowed Amount |
64300 |
Total Medicare Payment Amount |
46403.3 |
Total Medicare Standardized Payment Amount |
45532.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
57 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
1836 |
Total Drug Medicare AllowedAmount |
593.09 |
Total Drug Medicare PaymentAmount |
536.56 |
Total Drug Medicare Standardized Payment Amount |
536.56 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
712 |
Number Of Medicare Beneficiaries With Medical Services |
205 |
Total Medical Submitted Charge Amount |
157230.5 |
Total Medical Medicare Allowed Amount |
63706.91 |
Total Medical Medicare Payment Amount |
45866.74 |
Total Medical Medicare Standardized Payment Amount |
44996.37 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
34 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
101 |
Number Of Male Beneficiaries |
104 |
Number Of Non Hispanic White Beneficiaries |
161 |
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 |
168 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3583 |