| National Provider Identifier [NPI]: | 1083650733 |
| Last Name Of The Provider | COBB |
| First Name Of The Provider | CARL |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 115 PORTER DR |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | MIDDLEBURY |
| Zip Code Of The Provider | 057538423 |
| State Code Of The Provider | VT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 148 |
| Number Of Services | 4901 |
| Number Of Medicare Beneficiaries | 2297 |
| Total Submitted Charge Amount | 375335 |
| Total Medicare Allowed Amount | 114436 |
| Total Medicare Payment Amount | 86728.76 |
| Total Medicare Standardized Payment Amount | 88662.24 |
| 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 | 148 |
| Number Of Medical Services | 4901 |
| Number Of Medicare Beneficiaries With Medical Services | 2297 |
| Total Medical Submitted Charge Amount | 375335 |
| Total Medical Medicare Allowed Amount | 114436 |
| Total Medical Medicare Payment Amount | 86728.76 |
| Total Medical Medicare Standardized Payment Amount | 88662.24 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 360 |
| Number Of Beneficiaries Age 65 to 74 | 939 |
| Number Of Beneficiaries Age 75 to 84 | 641 |
| Number Of Beneficiaries Age Greater 84 | 357 |
| Number Of Female Beneficiaries | 1483 |
| Number Of Male Beneficiaries | 814 |
| Number Of Non Hispanic White Beneficiaries | 2239 |
| 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 | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1695 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 602 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0383 |