Medicare Facts for Dr. Shancy K. Jacob, DO


National Provider Identifier [NPI]: 1194031641
Last Name Of The Provider JACOB
First Name Of The Provider SHANCY
Middle Initial Of The Provider
Credentials Of The Provider D.O.
Gender Of The Provider F
Entity Type Of The Provider I
Street Address 1 Of The Provider 301 UNIVERSITY BLVD
Street Address 2 Of The Provider 4.200 JOHN SEALY ANNEX
City Of The Provider GALVESTON
Zip Code Of The Provider 775550562
State Code Of The Provider TX
Country Code Of The Provider US
Provider Type Of The Provider Internal Medicine
Medicare Participation Indicator Y
Number Of HCPCS 12
Number Of Services 274
Number Of Medicare Beneficiaries 103
Total Submitted Charge Amount 74683
Total Medicare Allowed Amount 24103.13
Total Medicare Payment Amount 18841.72
Total Medicare Standardized Payment Amount 19501.19
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 12
Number Of Medical Services 274
Number Of Medicare Beneficiaries With Medical Services 103
Total Medical Submitted Charge Amount 74683
Total Medical Medicare Allowed Amount 24103.13
Total Medical Medicare Payment Amount 18841.72
Total Medical Medicare Standardized Payment Amount 19501.19
Average Age Of Beneficiaries 72
Number Of Beneficiaries Age Less65 26
Number Of Beneficiaries Age 65 to 74 26
Number Of Beneficiaries Age 75 to 84 37
Number Of Beneficiaries Age Greater 84 14
Number Of Female Beneficiaries 49
Number Of Male Beneficiaries 54
Number Of Non Hispanic White Beneficiaries 85
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
Number Of Beneficiaries With Medicare Only Entitlement 72
Number Of Beneficiaries With Medicare Medicaid Entitlement 31
Percent Of With Atrial Fibrillation 37
Percent Of With Alzheimers Disease or Dementia 33
Percent Of With Asthma 15
Percent Of With Cancer 15
Percent Of With Heart Failure 70
Percent Of With Chronic Kidney Disease 58
Percent Of With Chronic Obstructive Pulmonary Disease 55
Percent Of With Depression 42
Percent Of With Diabetes 54
Percent Of With Hyperlipidemia 66
Percent Of With Hypertension 75
Percent Of With Ischemic Heart Disease 66
Percent Of With Osteoporosis 14
Percent Of With Rheumatoid Arthritis Osteoarthritis 57
Percent Of With Schizophrenia Other PsychoticDisorders 14
Percent Of With Stroke 26
Average HCC Risk Score Of Beneficiaries 2.0128

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