| National Provider Identifier [NPI]: | 1790759728 |
| Last Name Of The Provider | JACOBSON |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 1ST ST SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCHESTER |
| Zip Code Of The Provider | 559050001 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pediatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 7 |
| Number Of Services | 4973 |
| Number Of Medicare Beneficiaries | 2485 |
| Total Submitted Charge Amount | 141696.87 |
| Total Medicare Allowed Amount | 139311.6 |
| Total Medicare Payment Amount | 133698.01 |
| Total Medicare Standardized Payment Amount | 134968.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 2486 |
| Number Of Medicare Beneficiaries With Drug Services | 2483 |
| Total Drug Submitted ChargeAmount | 78861.87 |
| Total Drug Medicare AllowedAmount | 76861.56 |
| Total Drug Medicare PaymentAmount | 73869.71 |
| Total Drug Medicare Standardized Payment Amount | 73869.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 2 |
| Number Of Medical Services | 2487 |
| Number Of Medicare Beneficiaries With Medical Services | 2484 |
| Total Medical Submitted Charge Amount | 62835 |
| Total Medical Medicare Allowed Amount | 62450.04 |
| Total Medical Medicare Payment Amount | 59828.3 |
| Total Medical Medicare Standardized Payment Amount | 61098.64 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 154 |
| Number Of Beneficiaries Age 65 to 74 | 1222 |
| Number Of Beneficiaries Age 75 to 84 | 862 |
| Number Of Beneficiaries Age Greater 84 | 247 |
| Number Of Female Beneficiaries | 1382 |
| Number Of Male Beneficiaries | 1103 |
| Number Of Non Hispanic White Beneficiaries | 2379 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 44 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2350 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 135 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 34 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 1 |
| Average HCC Risk Score Of Beneficiaries | 0.7839 |