| National Provider Identifier [NPI]: | 1962623447 |
| Last Name Of The Provider | JACOBSON |
| First Name Of The Provider | BRENT |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8647 COACHLIGHT WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | LITTLETON |
| Zip Code Of The Provider | 801259651 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 137 |
| Number Of Services | 3931 |
| Number Of Medicare Beneficiaries | 3107 |
| Total Submitted Charge Amount | 1012297.76 |
| Total Medicare Allowed Amount | 143822.67 |
| Total Medicare Payment Amount | 110099.83 |
| Total Medicare Standardized Payment Amount | 113222.19 |
| Drug Suppress Indicator | * |
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| Number Of Medicare Beneficiaries With Drug Services | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 757 |
| Number Of Beneficiaries Age 65 to 74 | 885 |
| Number Of Beneficiaries Age 75 to 84 | 831 |
| Number Of Beneficiaries Age Greater 84 | 634 |
| Number Of Female Beneficiaries | 1823 |
| Number Of Male Beneficiaries | 1284 |
| Number Of Non Hispanic White Beneficiaries | 1620 |
| Number Of Black or African American Beneficiaries | 1052 |
| Number Of AsianPacific Islander Beneficiaries | 55 |
| Number Of Hispanic Beneficiaries | 344 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1891 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1216 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.2838 |