| National Provider Identifier [NPI]: | 1336263326 |
| Last Name Of The Provider | COBB |
| First Name Of The Provider | SHAWN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | FNP-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1013 BEARDS HILL RD |
| Street Address 2 Of The Provider | SUITE 103 |
| City Of The Provider | ABERDEEN |
| Zip Code Of The Provider | 210012293 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 293 |
| Number Of Medicare Beneficiaries | 145 |
| Total Submitted Charge Amount | 36367 |
| Total Medicare Allowed Amount | 19131.16 |
| Total Medicare Payment Amount | 13443.95 |
| Total Medicare Standardized Payment Amount | 15106.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 30 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 846 |
| Total Drug Medicare AllowedAmount | 735.09 |
| Total Drug Medicare PaymentAmount | 718.29 |
| Total Drug Medicare Standardized Payment Amount | 718.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 263 |
| Number Of Medicare Beneficiaries With Medical Services | 145 |
| Total Medical Submitted Charge Amount | 35521 |
| Total Medical Medicare Allowed Amount | 18396.07 |
| Total Medical Medicare Payment Amount | 12725.66 |
| Total Medical Medicare Standardized Payment Amount | 14388.67 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 61 |
| Number Of Beneficiaries Age 75 to 84 | 36 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 82 |
| Number Of Male Beneficiaries | 63 |
| Number Of Non Hispanic White Beneficiaries | 115 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 118 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.1374 |