| National Provider Identifier [NPI]: | 1417915190 |
| Last Name Of The Provider | JACOBSON |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 500 VONDERBURG DR |
| Street Address 2 Of The Provider | SUITE 303-E |
| City Of The Provider | BRANDON |
| Zip Code Of The Provider | 335115964 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 13390 |
| Number Of Medicare Beneficiaries | 1022 |
| Total Submitted Charge Amount | 854746.85 |
| Total Medicare Allowed Amount | 554275.99 |
| Total Medicare Payment Amount | 401026.79 |
| Total Medicare Standardized Payment Amount | 406607.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 4387 |
| Number Of Medicare Beneficiaries With Drug Services | 410 |
| Total Drug Submitted ChargeAmount | 122762.85 |
| Total Drug Medicare AllowedAmount | 68647.99 |
| Total Drug Medicare PaymentAmount | 55030.94 |
| Total Drug Medicare Standardized Payment Amount | 55030.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 9003 |
| Number Of Medicare Beneficiaries With Medical Services | 1022 |
| Total Medical Submitted Charge Amount | 731984 |
| Total Medical Medicare Allowed Amount | 485628 |
| Total Medical Medicare Payment Amount | 345995.85 |
| Total Medical Medicare Standardized Payment Amount | 351576.8 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 412 |
| Number Of Beneficiaries Age 75 to 84 | 365 |
| Number Of Beneficiaries Age Greater 84 | 174 |
| Number Of Female Beneficiaries | 549 |
| Number Of Male Beneficiaries | 473 |
| Number Of Non Hispanic White Beneficiaries | 921 |
| Number Of Black or African American Beneficiaries | 35 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 986 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0999 |