National Provider Identifier [NPI]: |
1285644617 |
Last Name Of The Provider |
JACOBSON |
First Name Of The Provider |
JERRY |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1633 S COURT ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
VISALIA |
Zip Code Of The Provider |
932774945 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
1455 |
Number Of Medicare Beneficiaries |
777 |
Total Submitted Charge Amount |
510643 |
Total Medicare Allowed Amount |
147706.66 |
Total Medicare Payment Amount |
113132.47 |
Total Medicare Standardized Payment Amount |
111805.07 |
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 |
41 |
Number Of Medical Services |
1455 |
Number Of Medicare Beneficiaries With Medical Services |
777 |
Total Medical Submitted Charge Amount |
510643 |
Total Medical Medicare Allowed Amount |
147706.66 |
Total Medical Medicare Payment Amount |
113132.47 |
Total Medical Medicare Standardized Payment Amount |
111805.07 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
169 |
Number Of Beneficiaries Age 65 to 74 |
215 |
Number Of Beneficiaries Age 75 to 84 |
221 |
Number Of Beneficiaries Age Greater 84 |
172 |
Number Of Female Beneficiaries |
432 |
Number Of Male Beneficiaries |
345 |
Number Of Non Hispanic White Beneficiaries |
484 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
19 |
Number Of Hispanic Beneficiaries |
251 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
385 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
392 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.2432 |