| National Provider Identifier [NPI]: | 1093792640 |
| Last Name Of The Provider | JACOB |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 26800 CROWN VALLEY PKWY |
| Street Address 2 Of The Provider | SUITE 250 |
| City Of The Provider | MISSION VIEJO |
| Zip Code Of The Provider | 926916384 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 8600 |
| Number Of Medicare Beneficiaries | 1408 |
| Total Submitted Charge Amount | 1145215.46 |
| Total Medicare Allowed Amount | 561689.75 |
| Total Medicare Payment Amount | 427582.62 |
| Total Medicare Standardized Payment Amount | 385414.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 303 |
| Number Of Medicare Beneficiaries With Drug Services | 79 |
| Total Drug Submitted ChargeAmount | 105078 |
| Total Drug Medicare AllowedAmount | 15497.6 |
| Total Drug Medicare PaymentAmount | 12160.64 |
| Total Drug Medicare Standardized Payment Amount | 12160.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 106 |
| Number Of Medical Services | 8297 |
| Number Of Medicare Beneficiaries With Medical Services | 1408 |
| Total Medical Submitted Charge Amount | 1040137.46 |
| Total Medical Medicare Allowed Amount | 546192.15 |
| Total Medical Medicare Payment Amount | 415421.98 |
| Total Medical Medicare Standardized Payment Amount | 373253.68 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 462 |
| Number Of Beneficiaries Age 75 to 84 | 546 |
| Number Of Beneficiaries Age Greater 84 | 347 |
| Number Of Female Beneficiaries | 689 |
| Number Of Male Beneficiaries | 719 |
| Number Of Non Hispanic White Beneficiaries | 1267 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 43 |
| Number Of Hispanic Beneficiaries | 57 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1314 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 94 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.5919 |