National Provider Identifier [NPI]: |
1609822915 |
Last Name Of The Provider |
COOK |
First Name Of The Provider |
TERRENCE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2042 CENTRAL AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
AUGUSTA |
Zip Code Of The Provider |
309044128 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Allergy/Immunology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
7693 |
Number Of Medicare Beneficiaries |
397 |
Total Submitted Charge Amount |
185102.49 |
Total Medicare Allowed Amount |
125499.69 |
Total Medicare Payment Amount |
91026.88 |
Total Medicare Standardized Payment Amount |
96779.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
186 |
Number Of Medicare Beneficiaries With Drug Services |
171 |
Total Drug Submitted ChargeAmount |
4800 |
Total Drug Medicare AllowedAmount |
4450.95 |
Total Drug Medicare PaymentAmount |
4181.66 |
Total Drug Medicare Standardized Payment Amount |
4181.66 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
7507 |
Number Of Medicare Beneficiaries With Medical Services |
397 |
Total Medical Submitted Charge Amount |
180302.49 |
Total Medical Medicare Allowed Amount |
121048.74 |
Total Medical Medicare Payment Amount |
86845.22 |
Total Medical Medicare Standardized Payment Amount |
92597.58 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
219 |
Number Of Beneficiaries Age 75 to 84 |
115 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
275 |
Number Of Male Beneficiaries |
122 |
Number Of Non Hispanic White Beneficiaries |
308 |
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 |
357 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
35 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.865 |