| National Provider Identifier [NPI]: | 1275627325 |
| Last Name Of The Provider | COCKBURN |
| First Name Of The Provider | DIANE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | ANP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 875 OAK ST SE |
| Street Address 2 Of The Provider | SUITE 4030 |
| City Of The Provider | SALEM |
| Zip Code Of The Provider | 973013975 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 112 |
| Number Of Services | 62073 |
| Number Of Medicare Beneficiaries | 377 |
| Total Submitted Charge Amount | 2942859.65 |
| Total Medicare Allowed Amount | 1451858.85 |
| Total Medicare Payment Amount | 1136807.92 |
| Total Medicare Standardized Payment Amount | 1149826.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 73 |
| Number Of Drug Services | 59244 |
| Number Of Medicare Beneficiaries With Drug Services | 247 |
| Total Drug Submitted ChargeAmount | 2542726.97 |
| Total Drug Medicare AllowedAmount | 1341078.3 |
| Total Drug Medicare PaymentAmount | 1049462.26 |
| Total Drug Medicare Standardized Payment Amount | 1049462.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 2829 |
| Number Of Medicare Beneficiaries With Medical Services | 377 |
| Total Medical Submitted Charge Amount | 400132.68 |
| Total Medical Medicare Allowed Amount | 110780.55 |
| Total Medical Medicare Payment Amount | 87345.66 |
| Total Medical Medicare Standardized Payment Amount | 100363.98 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 161 |
| Number Of Beneficiaries Age 75 to 84 | 120 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 205 |
| Number Of Male Beneficiaries | 172 |
| Number Of Non Hispanic White Beneficiaries | 346 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 306 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 71 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 46 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 2.0982 |