National Provider Identifier [NPI]: |
1790883429 |
Last Name Of The Provider |
COOPER |
First Name Of The Provider |
JENNA |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
CRNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
613 KINGS MOUNTAIN RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TUSCALOOSA |
Zip Code Of The Provider |
354062824 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
4465 |
Number Of Medicare Beneficiaries |
1023 |
Total Submitted Charge Amount |
376411.69 |
Total Medicare Allowed Amount |
265604.35 |
Total Medicare Payment Amount |
190137.9 |
Total Medicare Standardized Payment Amount |
243083.92 |
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 |
11 |
Number Of Medical Services |
4465 |
Number Of Medicare Beneficiaries With Medical Services |
1023 |
Total Medical Submitted Charge Amount |
376411.69 |
Total Medical Medicare Allowed Amount |
265604.35 |
Total Medical Medicare Payment Amount |
190137.9 |
Total Medical Medicare Standardized Payment Amount |
243083.92 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
110 |
Number Of Beneficiaries Age 65 to 74 |
194 |
Number Of Beneficiaries Age 75 to 84 |
346 |
Number Of Beneficiaries Age Greater 84 |
373 |
Number Of Female Beneficiaries |
682 |
Number Of Male Beneficiaries |
341 |
Number Of Non Hispanic White Beneficiaries |
741 |
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 |
477 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
546 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
62 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
53 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
68 |
Percent Of With Schizophrenia Other PsychoticDisorders |
22 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.253 |