| National Provider Identifier [NPI]: | 1871598342 |
| Last Name Of The Provider | MOOK |
| First Name Of The Provider | TOMMY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 255 BERT KOUNS LOOP |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHREVEPORT |
| Zip Code Of The Provider | 711068150 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 115 |
| Number Of Services | 12116 |
| Number Of Medicare Beneficiaries | 853 |
| Total Submitted Charge Amount | 1528842 |
| Total Medicare Allowed Amount | 403614.52 |
| Total Medicare Payment Amount | 307491.88 |
| Total Medicare Standardized Payment Amount | 325701.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 5162 |
| Number Of Medicare Beneficiaries With Drug Services | 75 |
| Total Drug Submitted ChargeAmount | 319989.5 |
| Total Drug Medicare AllowedAmount | 105247.37 |
| Total Drug Medicare PaymentAmount | 82032.03 |
| Total Drug Medicare Standardized Payment Amount | 82032.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 102 |
| Number Of Medical Services | 6954 |
| Number Of Medicare Beneficiaries With Medical Services | 853 |
| Total Medical Submitted Charge Amount | 1208852.5 |
| Total Medical Medicare Allowed Amount | 298367.15 |
| Total Medical Medicare Payment Amount | 225459.85 |
| Total Medical Medicare Standardized Payment Amount | 243669.79 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 353 |
| Number Of Beneficiaries Age 75 to 84 | 335 |
| Number Of Beneficiaries Age Greater 84 | 124 |
| Number Of Female Beneficiaries | 218 |
| Number Of Male Beneficiaries | 635 |
| Number Of Non Hispanic White Beneficiaries | 743 |
| Number Of Black or African American Beneficiaries | 94 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 811 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1441 |