| National Provider Identifier [NPI]: | 1932202330 |
| Last Name Of The Provider | JACOBS |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1400 116TH AVE NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | BELLEVUE |
| Zip Code Of The Provider | 98004 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 141 |
| Number Of Services | 9143 |
| Number Of Medicare Beneficiaries | 1008 |
| Total Submitted Charge Amount | 1109213 |
| Total Medicare Allowed Amount | 250712.31 |
| Total Medicare Payment Amount | 196737.23 |
| Total Medicare Standardized Payment Amount | 177945.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 7039 |
| Number Of Medicare Beneficiaries With Drug Services | 102 |
| Total Drug Submitted ChargeAmount | 11874 |
| Total Drug Medicare AllowedAmount | 2520.02 |
| Total Drug Medicare PaymentAmount | 1944.85 |
| Total Drug Medicare Standardized Payment Amount | 1944.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 136 |
| Number Of Medical Services | 2104 |
| Number Of Medicare Beneficiaries With Medical Services | 1008 |
| Total Medical Submitted Charge Amount | 1097339 |
| Total Medical Medicare Allowed Amount | 248192.29 |
| Total Medical Medicare Payment Amount | 194792.38 |
| Total Medical Medicare Standardized Payment Amount | 176000.46 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 500 |
| Number Of Beneficiaries Age 75 to 84 | 337 |
| Number Of Beneficiaries Age Greater 84 | 109 |
| Number Of Female Beneficiaries | 702 |
| Number Of Male Beneficiaries | 306 |
| Number Of Non Hispanic White Beneficiaries | 894 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 55 |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 828 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 180 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.88 |