| National Provider Identifier [NPI]: | 1225143316 |
| Last Name Of The Provider | JACOBI |
| First Name Of The Provider | SUSAN |
| 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 | 8421 PLUM DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | DES MOINES |
| Zip Code Of The Provider | 503227356 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 27137 |
| Number Of Medicare Beneficiaries | 668 |
| Total Submitted Charge Amount | 1263936 |
| Total Medicare Allowed Amount | 836678.93 |
| Total Medicare Payment Amount | 634881.48 |
| Total Medicare Standardized Payment Amount | 645598.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 20551 |
| Number Of Medicare Beneficiaries With Drug Services | 180 |
| Total Drug Submitted ChargeAmount | 806156 |
| Total Drug Medicare AllowedAmount | 643910.42 |
| Total Drug Medicare PaymentAmount | 487632.47 |
| Total Drug Medicare Standardized Payment Amount | 487632.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 6586 |
| Number Of Medicare Beneficiaries With Medical Services | 668 |
| Total Medical Submitted Charge Amount | 457780 |
| Total Medical Medicare Allowed Amount | 192768.51 |
| Total Medical Medicare Payment Amount | 147249.01 |
| Total Medical Medicare Standardized Payment Amount | 157965.63 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 90 |
| Number Of Beneficiaries Age 65 to 74 | 324 |
| Number Of Beneficiaries Age 75 to 84 | 189 |
| Number Of Beneficiaries Age Greater 84 | 65 |
| Number Of Female Beneficiaries | 566 |
| Number Of Male Beneficiaries | 102 |
| Number Of Non Hispanic White Beneficiaries | 642 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 590 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 78 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 26 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9935 |