| National Provider Identifier [NPI]: | 1710979224 |
| Last Name Of The Provider | COHEN |
| First Name Of The Provider | GARY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7131 RIDGE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191283251 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 854 |
| Number Of Medicare Beneficiaries | 227 |
| Total Submitted Charge Amount | 75950.2 |
| Total Medicare Allowed Amount | 59797.7 |
| Total Medicare Payment Amount | 41158.84 |
| Total Medicare Standardized Payment Amount | 38245.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 203 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 7357.2 |
| Total Drug Medicare AllowedAmount | 3023.41 |
| Total Drug Medicare PaymentAmount | 2496.49 |
| Total Drug Medicare Standardized Payment Amount | 2496.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 651 |
| Number Of Medicare Beneficiaries With Medical Services | 226 |
| Total Medical Submitted Charge Amount | 68593 |
| Total Medical Medicare Allowed Amount | 56774.29 |
| Total Medical Medicare Payment Amount | 38662.35 |
| Total Medical Medicare Standardized Payment Amount | 35749.41 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 88 |
| Number Of Beneficiaries Age 75 to 84 | 58 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 131 |
| Number Of Male Beneficiaries | 96 |
| Number Of Non Hispanic White Beneficiaries | 190 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 178 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7599 |