| National Provider Identifier [NPI]: | 1053509869 |
| Last Name Of The Provider | COTES |
| First Name Of The Provider | ENRIQUE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 15644 MADISON AVE |
| Street Address 2 Of The Provider | SUITE 218 |
| City Of The Provider | LAKEWOOD |
| Zip Code Of The Provider | 441075622 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 42277 |
| Number Of Medicare Beneficiaries | 4598 |
| Total Submitted Charge Amount | 1911167.02 |
| Total Medicare Allowed Amount | 492335.49 |
| Total Medicare Payment Amount | 482506.57 |
| Total Medicare Standardized Payment Amount | 479823.98 |
| 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 | 74 |
| Number Of Medical Services | 42277 |
| Number Of Medicare Beneficiaries With Medical Services | 4598 |
| Total Medical Submitted Charge Amount | 1911167.02 |
| Total Medical Medicare Allowed Amount | 492335.49 |
| Total Medical Medicare Payment Amount | 482506.57 |
| Total Medical Medicare Standardized Payment Amount | 479823.98 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 598 |
| Number Of Beneficiaries Age 65 to 74 | 1889 |
| Number Of Beneficiaries Age 75 to 84 | 1411 |
| Number Of Beneficiaries Age Greater 84 | 700 |
| Number Of Female Beneficiaries | 2680 |
| Number Of Male Beneficiaries | 1918 |
| Number Of Non Hispanic White Beneficiaries | 4033 |
| Number Of Black or African American Beneficiaries | 190 |
| Number Of AsianPacific Islander Beneficiaries | 104 |
| Number Of Hispanic Beneficiaries | 183 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3793 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 805 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1506 |