| National Provider Identifier [NPI]: | 1841274412 |
| Last Name Of The Provider | JACOBY |
| First Name Of The Provider | KARNY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6005 244TH ST SW |
| Street Address 2 Of The Provider | STE 111 |
| City Of The Provider | MOUNTLAKE TERRACE |
| Zip Code Of The Provider | 98043 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 6907 |
| Number Of Medicare Beneficiaries | 554 |
| Total Submitted Charge Amount | 580713.99 |
| Total Medicare Allowed Amount | 270751.21 |
| Total Medicare Payment Amount | 203406.47 |
| Total Medicare Standardized Payment Amount | 206379.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 3275 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 21095.23 |
| Total Drug Medicare AllowedAmount | 17253.87 |
| Total Drug Medicare PaymentAmount | 13403.67 |
| Total Drug Medicare Standardized Payment Amount | 13403.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 106 |
| Number Of Medical Services | 3632 |
| Number Of Medicare Beneficiaries With Medical Services | 554 |
| Total Medical Submitted Charge Amount | 559618.76 |
| Total Medical Medicare Allowed Amount | 253497.34 |
| Total Medical Medicare Payment Amount | 190002.8 |
| Total Medical Medicare Standardized Payment Amount | 192976.16 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 183 |
| Number Of Beneficiaries Age 75 to 84 | 201 |
| Number Of Beneficiaries Age Greater 84 | 127 |
| Number Of Female Beneficiaries | 440 |
| Number Of Male Beneficiaries | 114 |
| Number Of Non Hispanic White Beneficiaries | 509 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| 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 | 496 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.167 |