| National Provider Identifier [NPI]: | 1922072800 |
| Last Name Of The Provider | COYNIK |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4413 N. PROGRESS BLVD. |
| Street Address 2 Of The Provider | |
| City Of The Provider | PERU |
| Zip Code Of The Provider | 613542763 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 4516 |
| Number Of Medicare Beneficiaries | 1406 |
| Total Submitted Charge Amount | 406789.5 |
| Total Medicare Allowed Amount | 266531.59 |
| Total Medicare Payment Amount | 191530.42 |
| Total Medicare Standardized Payment Amount | 204537.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 665 |
| Number Of Medicare Beneficiaries With Drug Services | 64 |
| Total Drug Submitted ChargeAmount | 1662.5 |
| Total Drug Medicare AllowedAmount | 1185.35 |
| Total Drug Medicare PaymentAmount | 877 |
| Total Drug Medicare Standardized Payment Amount | 877 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 3851 |
| Number Of Medicare Beneficiaries With Medical Services | 1406 |
| Total Medical Submitted Charge Amount | 405127 |
| Total Medical Medicare Allowed Amount | 265346.24 |
| Total Medical Medicare Payment Amount | 190653.42 |
| Total Medical Medicare Standardized Payment Amount | 203660.16 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 84 |
| Number Of Beneficiaries Age 65 to 74 | 588 |
| Number Of Beneficiaries Age 75 to 84 | 469 |
| Number Of Beneficiaries Age Greater 84 | 265 |
| Number Of Female Beneficiaries | 753 |
| Number Of Male Beneficiaries | 653 |
| Number Of Non Hispanic White Beneficiaries | 1373 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1298 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 108 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0201 |