| National Provider Identifier [NPI]: | 1457572216 |
| Last Name Of The Provider | COHEN |
| First Name Of The Provider | INBAL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 655 WEST 8TH STREET |
| Street Address 2 Of The Provider | UFJP RADIOLOGY DEPT |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 32209 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pediatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 725 |
| Number Of Medicare Beneficiaries | 475 |
| Total Submitted Charge Amount | 231609 |
| Total Medicare Allowed Amount | 39447.13 |
| Total Medicare Payment Amount | 29076.04 |
| Total Medicare Standardized Payment Amount | 29266.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 725 |
| Number Of Medicare Beneficiaries With Medical Services | 475 |
| Total Medical Submitted Charge Amount | 231609 |
| Total Medical Medicare Allowed Amount | 39447.13 |
| Total Medical Medicare Payment Amount | 29076.04 |
| Total Medical Medicare Standardized Payment Amount | 29266.2 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 185 |
| Number Of Beneficiaries Age 65 to 74 | 149 |
| Number Of Beneficiaries Age 75 to 84 | 99 |
| Number Of Beneficiaries Age Greater 84 | 42 |
| Number Of Female Beneficiaries | 256 |
| Number Of Male Beneficiaries | 219 |
| Number Of Non Hispanic White Beneficiaries | 229 |
| Number Of Black or African American Beneficiaries | 217 |
| 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 | 183 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 292 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 24 |
| Average HCC Risk Score Of Beneficiaries | 2.1345 |