| National Provider Identifier [NPI]: | 1265867170 |
| Last Name Of The Provider | COBB-LUCIEN |
| First Name Of The Provider | VICKIE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MS,ARNP,FNP-BC,CHPN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1098 MONTGOMERY RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ALTAMONTE SPRINGS |
| Zip Code Of The Provider | 327147420 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 244 |
| Number Of Medicare Beneficiaries | 140 |
| Total Submitted Charge Amount | 10381.18 |
| Total Medicare Allowed Amount | 9424.13 |
| Total Medicare Payment Amount | 7922.06 |
| Total Medicare Standardized Payment Amount | 8982.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 85 |
| Number Of Medicare Beneficiaries With Drug Services | 80 |
| Total Drug Submitted ChargeAmount | 2659.18 |
| Total Drug Medicare AllowedAmount | 2659.18 |
| Total Drug Medicare PaymentAmount | 2605.38 |
| Total Drug Medicare Standardized Payment Amount | 2605.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 159 |
| Number Of Medicare Beneficiaries With Medical Services | 140 |
| Total Medical Submitted Charge Amount | 7722 |
| Total Medical Medicare Allowed Amount | 6764.95 |
| Total Medical Medicare Payment Amount | 5316.68 |
| Total Medical Medicare Standardized Payment Amount | 6377.2 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 68 |
| Number Of Beneficiaries Age 75 to 84 | 44 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 87 |
| Number Of Male Beneficiaries | 53 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8064 |