| National Provider Identifier [NPI]: | 1316128432 |
| Last Name Of The Provider | JACOME |
| First Name Of The Provider | FRANCISCO |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2101 CENTRAL AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUGUSTA |
| Zip Code Of The Provider | 309046706 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 449 |
| Number Of Medicare Beneficiaries | 187 |
| Total Submitted Charge Amount | 347656 |
| Total Medicare Allowed Amount | 117348.44 |
| Total Medicare Payment Amount | 90068.14 |
| Total Medicare Standardized Payment Amount | 94380.13 |
| 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 | 58 |
| Number Of Medical Services | 449 |
| Number Of Medicare Beneficiaries With Medical Services | 187 |
| Total Medical Submitted Charge Amount | 347656 |
| Total Medical Medicare Allowed Amount | 117348.44 |
| Total Medical Medicare Payment Amount | 90068.14 |
| Total Medical Medicare Standardized Payment Amount | 94380.13 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 91 |
| Number Of Beneficiaries Age 65 to 74 | 57 |
| Number Of Beneficiaries Age 75 to 84 | 27 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 135 |
| Number Of Male Beneficiaries | 52 |
| Number Of Non Hispanic White Beneficiaries | 113 |
| Number Of Black or African American Beneficiaries | 60 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 128 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3683 |