National Provider Identifier [NPI]: |
1891759213 |
Last Name Of The Provider |
COOK |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9001 S 101ST EAST AVE |
Street Address 2 Of The Provider |
STE 230 |
City Of The Provider |
TULSA |
Zip Code Of The Provider |
741335708 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
3208 |
Number Of Medicare Beneficiaries |
266 |
Total Submitted Charge Amount |
393265 |
Total Medicare Allowed Amount |
180903.79 |
Total Medicare Payment Amount |
135225.02 |
Total Medicare Standardized Payment Amount |
142981.02 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
1362 |
Number Of Medicare Beneficiaries With Drug Services |
92 |
Total Drug Submitted ChargeAmount |
51664 |
Total Drug Medicare AllowedAmount |
22326.31 |
Total Drug Medicare PaymentAmount |
18060.81 |
Total Drug Medicare Standardized Payment Amount |
18060.81 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
1846 |
Number Of Medicare Beneficiaries With Medical Services |
266 |
Total Medical Submitted Charge Amount |
341601 |
Total Medical Medicare Allowed Amount |
158577.48 |
Total Medical Medicare Payment Amount |
117164.21 |
Total Medical Medicare Standardized Payment Amount |
124920.21 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
116 |
Number Of Beneficiaries Age 75 to 84 |
99 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
143 |
Number Of Male Beneficiaries |
123 |
Number Of Non Hispanic White Beneficiaries |
243 |
Number Of Black or African American Beneficiaries |
12 |
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 |
242 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
26 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.2502 |