National Provider Identifier [NPI]: |
1417967928 |
Last Name Of The Provider |
COOK |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8440 WALNUT HILL LN |
Street Address 2 Of The Provider |
#110 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752313833 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
75 |
Number Of Services |
2585 |
Number Of Medicare Beneficiaries |
524 |
Total Submitted Charge Amount |
679976.84 |
Total Medicare Allowed Amount |
218728.57 |
Total Medicare Payment Amount |
165031.47 |
Total Medicare Standardized Payment Amount |
165129.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
169 |
Number Of Medicare Beneficiaries With Drug Services |
107 |
Total Drug Submitted ChargeAmount |
6515 |
Total Drug Medicare AllowedAmount |
972.22 |
Total Drug Medicare PaymentAmount |
733.47 |
Total Drug Medicare Standardized Payment Amount |
733.47 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
74 |
Number Of Medical Services |
2416 |
Number Of Medicare Beneficiaries With Medical Services |
524 |
Total Medical Submitted Charge Amount |
673461.84 |
Total Medical Medicare Allowed Amount |
217756.35 |
Total Medical Medicare Payment Amount |
164298 |
Total Medical Medicare Standardized Payment Amount |
164395.54 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
317 |
Number Of Beneficiaries Age 75 to 84 |
144 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
376 |
Number Of Male Beneficiaries |
148 |
Number Of Non Hispanic White Beneficiaries |
480 |
Number Of Black or African American Beneficiaries |
18 |
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 |
504 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
15 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9225 |