| National Provider Identifier [NPI]: | 1205836947 |
| Last Name Of The Provider | COHEN |
| First Name Of The Provider | JACK |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 71 W 156TH ST |
| Street Address 2 Of The Provider | STE 400 |
| City Of The Provider | HARVEY |
| Zip Code Of The Provider | 604264265 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 71 |
| Number Of Services | 15910 |
| Number Of Medicare Beneficiaries | 2534 |
| Total Submitted Charge Amount | 4184376.99 |
| Total Medicare Allowed Amount | 2919792.77 |
| Total Medicare Payment Amount | 2223468.51 |
| Total Medicare Standardized Payment Amount | 2165295.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 3809 |
| Number Of Medicare Beneficiaries With Drug Services | 322 |
| Total Drug Submitted ChargeAmount | 1735966.9 |
| Total Drug Medicare AllowedAmount | 1626530.75 |
| Total Drug Medicare PaymentAmount | 1272536.85 |
| Total Drug Medicare Standardized Payment Amount | 1272536.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 12101 |
| Number Of Medicare Beneficiaries With Medical Services | 2534 |
| Total Medical Submitted Charge Amount | 2448410.09 |
| Total Medical Medicare Allowed Amount | 1293262.02 |
| Total Medical Medicare Payment Amount | 950931.66 |
| Total Medical Medicare Standardized Payment Amount | 892758.42 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 190 |
| Number Of Beneficiaries Age 65 to 74 | 812 |
| Number Of Beneficiaries Age 75 to 84 | 863 |
| Number Of Beneficiaries Age Greater 84 | 669 |
| Number Of Female Beneficiaries | 1554 |
| Number Of Male Beneficiaries | 980 |
| Number Of Non Hispanic White Beneficiaries | 1924 |
| Number Of Black or African American Beneficiaries | 317 |
| Number Of AsianPacific Islander Beneficiaries | 87 |
| Number Of Hispanic Beneficiaries | 166 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2157 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 377 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4187 |