| National Provider Identifier [NPI]: | 1538111695 |
| Last Name Of The Provider | JACOBS |
| First Name Of The Provider | JACQUELYN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.P.M |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2248 MURRELL ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LYNCHBURG |
| Zip Code Of The Provider | 245012100 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 6452 |
| Number Of Medicare Beneficiaries | 1872 |
| Total Submitted Charge Amount | 462983.12 |
| Total Medicare Allowed Amount | 416168.38 |
| Total Medicare Payment Amount | 294921.8 |
| Total Medicare Standardized Payment Amount | 301345.8 |
| 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 | 40 |
| Number Of Medical Services | 6452 |
| Number Of Medicare Beneficiaries With Medical Services | 1872 |
| Total Medical Submitted Charge Amount | 462983.12 |
| Total Medical Medicare Allowed Amount | 416168.38 |
| Total Medical Medicare Payment Amount | 294921.8 |
| Total Medical Medicare Standardized Payment Amount | 301345.8 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 365 |
| Number Of Beneficiaries Age 65 to 74 | 363 |
| Number Of Beneficiaries Age 75 to 84 | 499 |
| Number Of Beneficiaries Age Greater 84 | 645 |
| Number Of Female Beneficiaries | 1241 |
| Number Of Male Beneficiaries | 631 |
| Number Of Non Hispanic White Beneficiaries | 1272 |
| Number Of Black or African American Beneficiaries | 579 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 668 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1204 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 50 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 18 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7213 |