| National Provider Identifier [NPI]: | 1548485816 |
| Last Name Of The Provider | BACON |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8329 BRIMHALL RD |
| Street Address 2 Of The Provider | SUITE 801 |
| City Of The Provider | BAKERSFIELD |
| Zip Code Of The Provider | 933122243 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 168281 |
| Number Of Medicare Beneficiaries | 608 |
| Total Submitted Charge Amount | 4768839 |
| Total Medicare Allowed Amount | 2839135.73 |
| Total Medicare Payment Amount | 2194599.66 |
| Total Medicare Standardized Payment Amount | 2178219.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 162381 |
| Number Of Medicare Beneficiaries With Drug Services | 311 |
| Total Drug Submitted ChargeAmount | 4312365 |
| Total Drug Medicare AllowedAmount | 2559910.01 |
| Total Drug Medicare PaymentAmount | 1985437.59 |
| Total Drug Medicare Standardized Payment Amount | 1985437.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 5900 |
| Number Of Medicare Beneficiaries With Medical Services | 608 |
| Total Medical Submitted Charge Amount | 456474 |
| Total Medical Medicare Allowed Amount | 279225.72 |
| Total Medical Medicare Payment Amount | 209162.07 |
| Total Medical Medicare Standardized Payment Amount | 192781.56 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 199 |
| Number Of Beneficiaries Age 65 to 74 | 250 |
| Number Of Beneficiaries Age 75 to 84 | 123 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 492 |
| Number Of Male Beneficiaries | 116 |
| Number Of Non Hispanic White Beneficiaries | 379 |
| Number Of Black or African American Beneficiaries | 29 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 168 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 357 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 251 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 21 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.3484 |