| National Provider Identifier [NPI]: | 1720303068 |
| Last Name Of The Provider | JACOBSEN |
| First Name Of The Provider | ANNE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8929 PARALLEL PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | KANSAS CITY |
| Zip Code Of The Provider | 661121689 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 683 |
| Number Of Medicare Beneficiaries | 585 |
| Total Submitted Charge Amount | 744467 |
| Total Medicare Allowed Amount | 108396.05 |
| Total Medicare Payment Amount | 83652.85 |
| Total Medicare Standardized Payment Amount | 86323.96 |
| 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 | 19 |
| Number Of Medical Services | 683 |
| Number Of Medicare Beneficiaries With Medical Services | 585 |
| Total Medical Submitted Charge Amount | 744467 |
| Total Medical Medicare Allowed Amount | 108396.05 |
| Total Medical Medicare Payment Amount | 83652.85 |
| Total Medical Medicare Standardized Payment Amount | 86323.96 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 150 |
| Number Of Beneficiaries Age 65 to 74 | 164 |
| Number Of Beneficiaries Age 75 to 84 | 147 |
| Number Of Beneficiaries Age Greater 84 | 124 |
| Number Of Female Beneficiaries | 369 |
| Number Of Male Beneficiaries | 216 |
| Number Of Non Hispanic White Beneficiaries | 375 |
| Number Of Black or African American Beneficiaries | 185 |
| 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 | 373 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 212 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.2074 |