| National Provider Identifier [NPI]: | 1730146218 |
| Last Name Of The Provider | JACOBS |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1800 HOLLISTER DR |
| Street Address 2 Of The Provider | SUITE 111 |
| City Of The Provider | LIBERTYVILLE |
| Zip Code Of The Provider | 600485263 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 4117 |
| Number Of Medicare Beneficiaries | 1316 |
| Total Submitted Charge Amount | 532769 |
| Total Medicare Allowed Amount | 443212 |
| Total Medicare Payment Amount | 314839.31 |
| Total Medicare Standardized Payment Amount | 295058.74 |
| 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 | 35 |
| Number Of Medical Services | 4117 |
| Number Of Medicare Beneficiaries With Medical Services | 1316 |
| Total Medical Submitted Charge Amount | 532769 |
| Total Medical Medicare Allowed Amount | 443212 |
| Total Medical Medicare Payment Amount | 314839.31 |
| Total Medical Medicare Standardized Payment Amount | 295058.74 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 123 |
| Number Of Beneficiaries Age 65 to 74 | 564 |
| Number Of Beneficiaries Age 75 to 84 | 440 |
| Number Of Beneficiaries Age Greater 84 | 189 |
| Number Of Female Beneficiaries | 832 |
| Number Of Male Beneficiaries | 484 |
| Number Of Non Hispanic White Beneficiaries | 922 |
| Number Of Black or African American Beneficiaries | 180 |
| Number Of AsianPacific Islander Beneficiaries | 49 |
| Number Of Hispanic Beneficiaries | 140 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1078 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 238 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1588 |