| National Provider Identifier [NPI]: | 1770501900 |
| Last Name Of The Provider | JACOBSON |
| First Name Of The Provider | ALAN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1870 W GALENA BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | AURORA |
| Zip Code Of The Provider | 605064356 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 8344 |
| Number Of Medicare Beneficiaries | 621 |
| Total Submitted Charge Amount | 720012 |
| Total Medicare Allowed Amount | 285578.47 |
| Total Medicare Payment Amount | 215838.1 |
| Total Medicare Standardized Payment Amount | 206724.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 769 |
| Number Of Medicare Beneficiaries With Drug Services | 264 |
| Total Drug Submitted ChargeAmount | 71238 |
| Total Drug Medicare AllowedAmount | 44204.66 |
| Total Drug Medicare PaymentAmount | 34830.34 |
| Total Drug Medicare Standardized Payment Amount | 34830.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 79 |
| Number Of Medical Services | 7575 |
| Number Of Medicare Beneficiaries With Medical Services | 621 |
| Total Medical Submitted Charge Amount | 648774 |
| Total Medical Medicare Allowed Amount | 241373.81 |
| Total Medical Medicare Payment Amount | 181007.76 |
| Total Medical Medicare Standardized Payment Amount | 171894.03 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 329 |
| Number Of Beneficiaries Age 75 to 84 | 168 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 442 |
| Number Of Male Beneficiaries | 179 |
| Number Of Non Hispanic White Beneficiaries | 524 |
| Number Of Black or African American Beneficiaries | 32 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 560 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 61 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.113 |