| National Provider Identifier [NPI]: | 1821091646 |
| Last Name Of The Provider | COBEN |
| First Name Of The Provider | MARCIE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12700 PARK CENTRAL DR |
| Street Address 2 Of The Provider | STE 430 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752511527 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 128 |
| Number Of Services | 3421 |
| Number Of Medicare Beneficiaries | 2399 |
| Total Submitted Charge Amount | 312221 |
| Total Medicare Allowed Amount | 93727.09 |
| Total Medicare Payment Amount | 70689.08 |
| Total Medicare Standardized Payment Amount | 71462.68 |
| 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 | 128 |
| Number Of Medical Services | 3421 |
| Number Of Medicare Beneficiaries With Medical Services | 2399 |
| Total Medical Submitted Charge Amount | 312221 |
| Total Medical Medicare Allowed Amount | 93727.09 |
| Total Medical Medicare Payment Amount | 70689.08 |
| Total Medical Medicare Standardized Payment Amount | 71462.68 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 417 |
| Number Of Beneficiaries Age 65 to 74 | 943 |
| Number Of Beneficiaries Age 75 to 84 | 640 |
| Number Of Beneficiaries Age Greater 84 | 399 |
| Number Of Female Beneficiaries | 1372 |
| Number Of Male Beneficiaries | 1027 |
| Number Of Non Hispanic White Beneficiaries | 1743 |
| Number Of Black or African American Beneficiaries | 340 |
| Number Of AsianPacific Islander Beneficiaries | 82 |
| Number Of Hispanic Beneficiaries | 194 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1843 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 556 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.1528 |