| National Provider Identifier [NPI]: | 1407949910 |
| Last Name Of The Provider | DECOOK |
| First Name Of The Provider | CECILIA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 382 N 120TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOLLAND |
| Zip Code Of The Provider | 49424 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 671 |
| Number Of Medicare Beneficiaries | 208 |
| Total Submitted Charge Amount | 49766 |
| Total Medicare Allowed Amount | 34570.7 |
| Total Medicare Payment Amount | 25393.54 |
| Total Medicare Standardized Payment Amount | 27084.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 108 |
| Number Of Medicare Beneficiaries With Drug Services | 58 |
| Total Drug Submitted ChargeAmount | 1446 |
| Total Drug Medicare AllowedAmount | 1017.35 |
| Total Drug Medicare PaymentAmount | 961.52 |
| Total Drug Medicare Standardized Payment Amount | 961.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 563 |
| Number Of Medicare Beneficiaries With Medical Services | 207 |
| Total Medical Submitted Charge Amount | 48320 |
| Total Medical Medicare Allowed Amount | 33553.35 |
| Total Medical Medicare Payment Amount | 24432.02 |
| Total Medical Medicare Standardized Payment Amount | 26122.57 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 78 |
| Number Of Beneficiaries Age 75 to 84 | 46 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 156 |
| Number Of Male Beneficiaries | 52 |
| Number Of Non Hispanic White Beneficiaries | 188 |
| 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 | 167 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1093 |