| National Provider Identifier [NPI]: | 1619966785 |
| Last Name Of The Provider | JEBSEN |
| First Name Of The Provider | DARRELL |
| 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 | 312 E MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MARSHALLTOWN |
| Zip Code Of The Provider | 501581888 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 170 |
| Number Of Services | 9968 |
| Number Of Medicare Beneficiaries | 676 |
| Total Submitted Charge Amount | 530524.76 |
| Total Medicare Allowed Amount | 232798.85 |
| Total Medicare Payment Amount | 167452.58 |
| Total Medicare Standardized Payment Amount | 180056.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 4236 |
| Number Of Medicare Beneficiaries With Drug Services | 326 |
| Total Drug Submitted ChargeAmount | 44114 |
| Total Drug Medicare AllowedAmount | 29845.58 |
| Total Drug Medicare PaymentAmount | 24870.9 |
| Total Drug Medicare Standardized Payment Amount | 24870.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 155 |
| Number Of Medical Services | 5732 |
| Number Of Medicare Beneficiaries With Medical Services | 676 |
| Total Medical Submitted Charge Amount | 486410.76 |
| Total Medical Medicare Allowed Amount | 202953.27 |
| Total Medical Medicare Payment Amount | 142581.68 |
| Total Medical Medicare Standardized Payment Amount | 155185.97 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 323 |
| Number Of Beneficiaries Age 75 to 84 | 200 |
| Number Of Beneficiaries Age Greater 84 | 106 |
| Number Of Female Beneficiaries | 316 |
| Number Of Male Beneficiaries | 360 |
| Number Of Non Hispanic White Beneficiaries | 651 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 613 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9124 |