National Provider Identifier [NPI]: |
1114993417 |
Last Name Of The Provider |
COOK |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2051 HAMILL RD |
Street Address 2 Of The Provider |
SUITE 204 |
City Of The Provider |
HIXSON |
Zip Code Of The Provider |
373436614 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
1467 |
Number Of Medicare Beneficiaries |
253 |
Total Submitted Charge Amount |
100635 |
Total Medicare Allowed Amount |
38801.64 |
Total Medicare Payment Amount |
29316.74 |
Total Medicare Standardized Payment Amount |
31458.4 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
104 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
117 |
Number Of Male Beneficiaries |
136 |
Number Of Non Hispanic White Beneficiaries |
238 |
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 |
239 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1293 |