| National Provider Identifier [NPI]: | 1952523698 |
| Last Name Of The Provider | JACOBS |
| First Name Of The Provider | MARILYN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 105 S BROADWAY ST |
| Street Address 2 Of The Provider | SUITE 730 |
| City Of The Provider | WICHITA |
| Zip Code Of The Provider | 672024227 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 4898 |
| Number Of Medicare Beneficiaries | 988 |
| Total Submitted Charge Amount | 802452.69 |
| Total Medicare Allowed Amount | 379600 |
| Total Medicare Payment Amount | 296322.71 |
| Total Medicare Standardized Payment Amount | 308301.74 |
| 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 | 10 |
| Number Of Medical Services | 4898 |
| Number Of Medicare Beneficiaries With Medical Services | 988 |
| Total Medical Submitted Charge Amount | 802452.69 |
| Total Medical Medicare Allowed Amount | 379600 |
| Total Medical Medicare Payment Amount | 296322.71 |
| Total Medical Medicare Standardized Payment Amount | 308301.74 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 122 |
| Number Of Beneficiaries Age 65 to 74 | 356 |
| Number Of Beneficiaries Age 75 to 84 | 325 |
| Number Of Beneficiaries Age Greater 84 | 185 |
| Number Of Female Beneficiaries | 565 |
| Number Of Male Beneficiaries | 423 |
| Number Of Non Hispanic White Beneficiaries | 896 |
| Number Of Black or African American Beneficiaries | 44 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 850 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 138 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 1.5071 |