| National Provider Identifier [NPI]: | 1407856214 |
| Last Name Of The Provider | JACOBS |
| First Name Of The Provider | NORMAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1805 27TH ST |
| Street Address 2 Of The Provider | SOMC |
| City Of The Provider | PORTSMOUTH |
| Zip Code Of The Provider | 45662 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 194 |
| Number Of Services | 5443 |
| Number Of Medicare Beneficiaries | 2974 |
| Total Submitted Charge Amount | 734785 |
| Total Medicare Allowed Amount | 236396.43 |
| Total Medicare Payment Amount | 184490.61 |
| Total Medicare Standardized Payment Amount | 190737.74 |
| 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 | 194 |
| Number Of Medical Services | 5443 |
| Number Of Medicare Beneficiaries With Medical Services | 2974 |
| Total Medical Submitted Charge Amount | 734785 |
| Total Medical Medicare Allowed Amount | 236396.43 |
| Total Medical Medicare Payment Amount | 184490.61 |
| Total Medical Medicare Standardized Payment Amount | 190737.74 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 772 |
| Number Of Beneficiaries Age 65 to 74 | 972 |
| Number Of Beneficiaries Age 75 to 84 | 825 |
| Number Of Beneficiaries Age Greater 84 | 405 |
| Number Of Female Beneficiaries | 1759 |
| Number Of Male Beneficiaries | 1215 |
| Number Of Non Hispanic White Beneficiaries | 2916 |
| Number Of Black or African American Beneficiaries | 31 |
| 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 | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1610 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1364 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.7436 |