| National Provider Identifier [NPI]: | 1831161397 |
| Last Name Of The Provider | COOK |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | NURSE PRACTITIONER |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 410 COUNCIL CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUPELO |
| Zip Code Of The Provider | 388014938 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 3566 |
| Number Of Medicare Beneficiaries | 543 |
| Total Submitted Charge Amount | 98299 |
| Total Medicare Allowed Amount | 57865.01 |
| Total Medicare Payment Amount | 36452.98 |
| Total Medicare Standardized Payment Amount | 48922.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 1992 |
| Number Of Medicare Beneficiaries With Drug Services | 240 |
| Total Drug Submitted ChargeAmount | 6748 |
| Total Drug Medicare AllowedAmount | 2476.4 |
| Total Drug Medicare PaymentAmount | 1533.76 |
| Total Drug Medicare Standardized Payment Amount | 1533.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 1574 |
| Number Of Medicare Beneficiaries With Medical Services | 543 |
| Total Medical Submitted Charge Amount | 91551 |
| Total Medical Medicare Allowed Amount | 55388.61 |
| Total Medical Medicare Payment Amount | 34919.22 |
| Total Medical Medicare Standardized Payment Amount | 47389.01 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 230 |
| Number Of Beneficiaries Age 65 to 74 | 192 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 33 |
| Number Of Female Beneficiaries | 347 |
| Number Of Male Beneficiaries | 196 |
| Number Of Non Hispanic White Beneficiaries | 337 |
| 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 | 312 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 231 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.9889 |