| National Provider Identifier [NPI]: | 1790739712 |
| Last Name Of The Provider | COOK |
| First Name Of The Provider | STEVEN |
| 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 | 2512 NEW PINE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | ALTOONA |
| Zip Code Of The Provider | 547201378 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 563 |
| Number Of Medicare Beneficiaries | 348 |
| Total Submitted Charge Amount | 209030.6 |
| Total Medicare Allowed Amount | 54703.17 |
| Total Medicare Payment Amount | 40390.58 |
| Total Medicare Standardized Payment Amount | 42432 |
| 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 | 20 |
| Number Of Medical Services | 563 |
| Number Of Medicare Beneficiaries With Medical Services | 348 |
| Total Medical Submitted Charge Amount | 209030.6 |
| Total Medical Medicare Allowed Amount | 54703.17 |
| Total Medical Medicare Payment Amount | 40390.58 |
| Total Medical Medicare Standardized Payment Amount | 42432 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 91 |
| Number Of Beneficiaries Age 65 to 74 | 89 |
| Number Of Beneficiaries Age 75 to 84 | 68 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 198 |
| Number Of Male Beneficiaries | 150 |
| Number Of Non Hispanic White Beneficiaries | 334 |
| 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 | 167 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 181 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.8909 |