National Provider Identifier [NPI]: |
1114095072 |
Last Name Of The Provider |
COOK |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10571 TELEGRAPH RD |
Street Address 2 Of The Provider |
SUITE 210 |
City Of The Provider |
GLEN ALLEN |
Zip Code Of The Provider |
230594652 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
427 |
Number Of Medicare Beneficiaries |
150 |
Total Submitted Charge Amount |
102780 |
Total Medicare Allowed Amount |
36282.29 |
Total Medicare Payment Amount |
25181.66 |
Total Medicare Standardized Payment Amount |
26318.42 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
42 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
4965 |
Total Drug Medicare AllowedAmount |
2081.88 |
Total Drug Medicare PaymentAmount |
2038.26 |
Total Drug Medicare Standardized Payment Amount |
2038.26 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
385 |
Number Of Medicare Beneficiaries With Medical Services |
150 |
Total Medical Submitted Charge Amount |
97815 |
Total Medical Medicare Allowed Amount |
34200.41 |
Total Medical Medicare Payment Amount |
23143.4 |
Total Medical Medicare Standardized Payment Amount |
24280.16 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
100 |
Number Of Male Beneficiaries |
50 |
Number Of Non Hispanic White Beneficiaries |
99 |
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 |
118 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.231 |