National Provider Identifier [NPI]: |
1912013426 |
Last Name Of The Provider |
COOKE |
First Name Of The Provider |
VICKY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1017 EXECUTIVE DR |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
HIXSON |
Zip Code Of The Provider |
373437910 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
2106 |
Number Of Medicare Beneficiaries |
292 |
Total Submitted Charge Amount |
211484.5 |
Total Medicare Allowed Amount |
105189.66 |
Total Medicare Payment Amount |
71348.18 |
Total Medicare Standardized Payment Amount |
93148.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
363 |
Number Of Medicare Beneficiaries With Drug Services |
141 |
Total Drug Submitted ChargeAmount |
10666.5 |
Total Drug Medicare AllowedAmount |
3805.9 |
Total Drug Medicare PaymentAmount |
3567.3 |
Total Drug Medicare Standardized Payment Amount |
3567.3 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
34 |
Number Of Medical Services |
1743 |
Number Of Medicare Beneficiaries With Medical Services |
292 |
Total Medical Submitted Charge Amount |
200818 |
Total Medical Medicare Allowed Amount |
101383.76 |
Total Medical Medicare Payment Amount |
67780.88 |
Total Medical Medicare Standardized Payment Amount |
89581.35 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
73 |
Number Of Beneficiaries Age 65 to 74 |
143 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
191 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
271 |
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 |
199 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
93 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2761 |