| National Provider Identifier [NPI]: | 1801886908 |
| Last Name Of The Provider | JACOBS |
| First Name Of The Provider | KAREN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 330 N WABASH AVE |
| Street Address 2 Of The Provider | SUITE 350 |
| City Of The Provider | MARION |
| Zip Code Of The Provider | 469522600 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 6680 |
| Number Of Medicare Beneficiaries | 893 |
| Total Submitted Charge Amount | 881934 |
| Total Medicare Allowed Amount | 341761.89 |
| Total Medicare Payment Amount | 252538.58 |
| Total Medicare Standardized Payment Amount | 265856 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1137 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 153265 |
| Total Drug Medicare AllowedAmount | 43263.99 |
| Total Drug Medicare PaymentAmount | 33466.61 |
| Total Drug Medicare Standardized Payment Amount | 33466.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 5543 |
| Number Of Medicare Beneficiaries With Medical Services | 893 |
| Total Medical Submitted Charge Amount | 728669 |
| Total Medical Medicare Allowed Amount | 298497.9 |
| Total Medical Medicare Payment Amount | 219071.97 |
| Total Medical Medicare Standardized Payment Amount | 232389.39 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 124 |
| Number Of Beneficiaries Age 65 to 74 | 317 |
| Number Of Beneficiaries Age 75 to 84 | 317 |
| Number Of Beneficiaries Age Greater 84 | 135 |
| Number Of Female Beneficiaries | 476 |
| Number Of Male Beneficiaries | 417 |
| Number Of Non Hispanic White Beneficiaries | 829 |
| Number Of Black or African American Beneficiaries | 41 |
| 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 | 711 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 182 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3609 |