| National Provider Identifier [NPI]: | 1992734503 |
| Last Name Of The Provider | COOPER |
| First Name Of The Provider | TERI |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 725 NORTH ST |
| Street Address 2 Of The Provider | BERKSHIRE MEDICAL CENTER LABORATORY |
| City Of The Provider | PITTSFIELD |
| Zip Code Of The Provider | 012014132 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 4069 |
| Number Of Medicare Beneficiaries | 1489 |
| Total Submitted Charge Amount | 702743 |
| Total Medicare Allowed Amount | 152189.6 |
| Total Medicare Payment Amount | 118585.97 |
| Total Medicare Standardized Payment Amount | 94064.66 |
| 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 | 28 |
| Number Of Medical Services | 4069 |
| Number Of Medicare Beneficiaries With Medical Services | 1489 |
| Total Medical Submitted Charge Amount | 702743 |
| Total Medical Medicare Allowed Amount | 152189.6 |
| Total Medical Medicare Payment Amount | 118585.97 |
| Total Medical Medicare Standardized Payment Amount | 94064.66 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 253 |
| Number Of Beneficiaries Age 65 to 74 | 604 |
| Number Of Beneficiaries Age 75 to 84 | 450 |
| Number Of Beneficiaries Age Greater 84 | 182 |
| Number Of Female Beneficiaries | 732 |
| Number Of Male Beneficiaries | 757 |
| Number Of Non Hispanic White Beneficiaries | 1434 |
| Number Of Black or African American Beneficiaries | 17 |
| 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 | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1134 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 355 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2114 |