| National Provider Identifier [NPI]: | 1750379236 |
| Last Name Of The Provider | COOK |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1425 W H ST |
| Street Address 2 Of The Provider | STE 200 |
| City Of The Provider | OAKDALE |
| Zip Code Of The Provider | 953613588 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 1704 |
| Number Of Medicare Beneficiaries | 186 |
| Total Submitted Charge Amount | 104033 |
| Total Medicare Allowed Amount | 89050.92 |
| Total Medicare Payment Amount | 61947.11 |
| Total Medicare Standardized Payment Amount | 61578.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 147 |
| Number Of Medicare Beneficiaries With Drug Services | 85 |
| Total Drug Submitted ChargeAmount | 5085 |
| Total Drug Medicare AllowedAmount | 3481.08 |
| Total Drug Medicare PaymentAmount | 3312.79 |
| Total Drug Medicare Standardized Payment Amount | 3312.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 1557 |
| Number Of Medicare Beneficiaries With Medical Services | 186 |
| Total Medical Submitted Charge Amount | 98948 |
| Total Medical Medicare Allowed Amount | 85569.84 |
| Total Medical Medicare Payment Amount | 58634.32 |
| Total Medical Medicare Standardized Payment Amount | 58265.54 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 102 |
| Number Of Beneficiaries Age 75 to 84 | 50 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 93 |
| Number Of Male Beneficiaries | 93 |
| Number Of Non Hispanic White Beneficiaries | 175 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 6 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 27 |
| Percent Of With Hypertension | 37 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7659 |