| National Provider Identifier [NPI]: | 1033530811 |
| Last Name Of The Provider | COOK |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2992 N MILLER RD UNIT 114 |
| Street Address 2 Of The Provider | |
| City Of The Provider | SCOTTSDALE |
| Zip Code Of The Provider | 852517943 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 53 |
| Number Of Medicare Beneficiaries | 30 |
| Total Submitted Charge Amount | 2165.98 |
| Total Medicare Allowed Amount | 1648.96 |
| Total Medicare Payment Amount | 1482.57 |
| Total Medicare Standardized Payment Amount | 1794.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 20 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 753.8 |
| Total Drug Medicare AllowedAmount | 624.74 |
| Total Drug Medicare PaymentAmount | 612.2 |
| Total Drug Medicare Standardized Payment Amount | 612.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 9 |
| Number Of Medical Services | 33 |
| Number Of Medicare Beneficiaries With Medical Services | 30 |
| Total Medical Submitted Charge Amount | 1412.18 |
| Total Medical Medicare Allowed Amount | 1024.22 |
| Total Medical Medicare Payment Amount | 870.37 |
| Total Medical Medicare Standardized Payment Amount | 1182.72 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 19 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| 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 | 0 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1219 |