| National Provider Identifier [NPI]: | 1306833199 |
| Last Name Of The Provider | COHEN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 50 MEDICAL PARK BOULEVARD |
| Street Address 2 Of The Provider | SUITE C & D |
| City Of The Provider | PETERSBURG |
| Zip Code Of The Provider | 238059289 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 2005 |
| Number Of Medicare Beneficiaries | 506 |
| Total Submitted Charge Amount | 448381 |
| Total Medicare Allowed Amount | 180762.67 |
| Total Medicare Payment Amount | 128180.18 |
| Total Medicare Standardized Payment Amount | 131965.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 78 |
| Number Of Medicare Beneficiaries With Drug Services | 76 |
| Total Drug Submitted ChargeAmount | 1587 |
| Total Drug Medicare AllowedAmount | 1274.89 |
| Total Drug Medicare PaymentAmount | 1242.27 |
| Total Drug Medicare Standardized Payment Amount | 1242.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 1927 |
| Number Of Medicare Beneficiaries With Medical Services | 506 |
| Total Medical Submitted Charge Amount | 446794 |
| Total Medical Medicare Allowed Amount | 179487.78 |
| Total Medical Medicare Payment Amount | 126937.91 |
| Total Medical Medicare Standardized Payment Amount | 130723 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 177 |
| Number Of Beneficiaries Age 75 to 84 | 179 |
| Number Of Beneficiaries Age Greater 84 | 132 |
| Number Of Female Beneficiaries | 327 |
| Number Of Male Beneficiaries | 179 |
| Number Of Non Hispanic White Beneficiaries | 317 |
| Number Of Black or African American Beneficiaries | 178 |
| 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 | 482 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.149 |