| National Provider Identifier [NPI]: | 1407826662 |
| Last Name Of The Provider | HAYCOOK |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | ONE ORTHOPAEDIC PLACE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST AUGUSTINE |
| Zip Code Of The Provider | 320864202 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 134 |
| Number Of Services | 2010 |
| Number Of Medicare Beneficiaries | 662 |
| Total Submitted Charge Amount | 1367173.85 |
| Total Medicare Allowed Amount | 450374.12 |
| Total Medicare Payment Amount | 343961.96 |
| Total Medicare Standardized Payment Amount | 329656.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 85 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 481.56 |
| Total Drug Medicare AllowedAmount | 326.26 |
| Total Drug Medicare PaymentAmount | 241.59 |
| Total Drug Medicare Standardized Payment Amount | 241.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 130 |
| Number Of Medical Services | 1925 |
| Number Of Medicare Beneficiaries With Medical Services | 662 |
| Total Medical Submitted Charge Amount | 1366692.29 |
| Total Medical Medicare Allowed Amount | 450047.86 |
| Total Medical Medicare Payment Amount | 343720.37 |
| Total Medical Medicare Standardized Payment Amount | 329415.38 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 78 |
| Number Of Beneficiaries Age 65 to 74 | 323 |
| Number Of Beneficiaries Age 75 to 84 | 188 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 400 |
| Number Of Male Beneficiaries | 262 |
| Number Of Non Hispanic White Beneficiaries | 609 |
| Number Of Black or African American Beneficiaries | 25 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 574 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 88 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 69 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2959 |