| National Provider Identifier [NPI]: | 1013978261 |
| Last Name Of The Provider | COOKE-SAMPSON |
| First Name Of The Provider | ESTELLE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 21 CROSSROADS DR |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | OWINGS MILLS |
| Zip Code Of The Provider | 211175441 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 2517 |
| Number Of Medicare Beneficiaries | 1449 |
| Total Submitted Charge Amount | 364689.33 |
| Total Medicare Allowed Amount | 65729.13 |
| Total Medicare Payment Amount | 49111.83 |
| Total Medicare Standardized Payment Amount | 49162.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 101 |
| Number Of Medical Services | 2517 |
| Number Of Medicare Beneficiaries With Medical Services | 1449 |
| Total Medical Submitted Charge Amount | 364689.33 |
| Total Medical Medicare Allowed Amount | 65729.13 |
| Total Medical Medicare Payment Amount | 49111.83 |
| Total Medical Medicare Standardized Payment Amount | 49162.59 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 286 |
| Number Of Beneficiaries Age 65 to 74 | 424 |
| Number Of Beneficiaries Age 75 to 84 | 436 |
| Number Of Beneficiaries Age Greater 84 | 303 |
| Number Of Female Beneficiaries | 864 |
| Number Of Male Beneficiaries | 585 |
| Number Of Non Hispanic White Beneficiaries | 1024 |
| Number Of Black or African American Beneficiaries | 393 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1038 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 411 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.997 |