| National Provider Identifier [NPI]: | 1891747291 |
| Last Name Of The Provider | COOLEY |
| First Name Of The Provider | VERNON |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1820 SIDEWINDER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | PARK CITY |
| Zip Code Of The Provider | 840607492 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 404 |
| Number Of Medicare Beneficiaries | 38 |
| Total Submitted Charge Amount | 39493.8 |
| Total Medicare Allowed Amount | 16983.15 |
| Total Medicare Payment Amount | 12074.38 |
| Total Medicare Standardized Payment Amount | 12525.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 289 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 5403.8 |
| Total Drug Medicare AllowedAmount | 3574.38 |
| Total Drug Medicare PaymentAmount | 2732 |
| Total Drug Medicare Standardized Payment Amount | 2732 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 115 |
| Number Of Medicare Beneficiaries With Medical Services | 38 |
| Total Medical Submitted Charge Amount | 34090 |
| Total Medical Medicare Allowed Amount | 13408.77 |
| Total Medical Medicare Payment Amount | 9342.38 |
| Total Medical Medicare Standardized Payment Amount | 9793.13 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 22 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 15 |
| Number Of Male Beneficiaries | 23 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 0 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 0 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 0 |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 42 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.686 |