| National Provider Identifier [NPI]: | 1558314971 |
| Last Name Of The Provider | JACOBSON |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7301 MEDICAL CENTER DR |
| Street Address 2 Of The Provider | STE. 404 |
| City Of The Provider | WEST HILLS |
| Zip Code Of The Provider | 913071904 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 3507 |
| Number Of Medicare Beneficiaries | 493 |
| Total Submitted Charge Amount | 366550 |
| Total Medicare Allowed Amount | 246669.33 |
| Total Medicare Payment Amount | 180348.36 |
| Total Medicare Standardized Payment Amount | 169845.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 494 |
| Number Of Medicare Beneficiaries With Drug Services | 242 |
| Total Drug Submitted ChargeAmount | 12150 |
| Total Drug Medicare AllowedAmount | 4267.58 |
| Total Drug Medicare PaymentAmount | 3767.16 |
| Total Drug Medicare Standardized Payment Amount | 3767.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 3013 |
| Number Of Medicare Beneficiaries With Medical Services | 493 |
| Total Medical Submitted Charge Amount | 354400 |
| Total Medical Medicare Allowed Amount | 242401.75 |
| Total Medical Medicare Payment Amount | 176581.2 |
| Total Medical Medicare Standardized Payment Amount | 166078.26 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 204 |
| Number Of Beneficiaries Age 75 to 84 | 164 |
| Number Of Beneficiaries Age Greater 84 | 106 |
| Number Of Female Beneficiaries | 274 |
| Number Of Male Beneficiaries | 219 |
| Number Of Non Hispanic White Beneficiaries | 430 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 447 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 46 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0561 |