| National Provider Identifier [NPI]: | 1255465852 |
| Last Name Of The Provider | JACOBS |
| First Name Of The Provider | AVRUM |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6801 MAYFIELD RD |
| Street Address 2 Of The Provider | SUITE 444 |
| City Of The Provider | MAYFIELD HTS |
| Zip Code Of The Provider | 441242270 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 2739 |
| Number Of Medicare Beneficiaries | 1053 |
| Total Submitted Charge Amount | 1103150 |
| Total Medicare Allowed Amount | 186038.38 |
| Total Medicare Payment Amount | 139605.05 |
| Total Medicare Standardized Payment Amount | 142037.51 |
| 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 | 34 |
| Number Of Medical Services | 2739 |
| Number Of Medicare Beneficiaries With Medical Services | 1053 |
| Total Medical Submitted Charge Amount | 1103150 |
| Total Medical Medicare Allowed Amount | 186038.38 |
| Total Medical Medicare Payment Amount | 139605.05 |
| Total Medical Medicare Standardized Payment Amount | 142037.51 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 344 |
| Number Of Beneficiaries Age 75 to 84 | 372 |
| Number Of Beneficiaries Age Greater 84 | 281 |
| Number Of Female Beneficiaries | 532 |
| Number Of Male Beneficiaries | 521 |
| Number Of Non Hispanic White Beneficiaries | 927 |
| Number Of Black or African American Beneficiaries | 93 |
| 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 | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 885 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 168 |
| Percent Of With Atrial Fibrillation | 40 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8676 |