| National Provider Identifier [NPI]: | 1396784484 |
| Last Name Of The Provider | JACOBS |
| First Name Of The Provider | RENEE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 310 CHESTNUT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEEDHAM |
| Zip Code Of The Provider | 024922411 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 1011 |
| Number Of Medicare Beneficiaries | 206 |
| Total Submitted Charge Amount | 187752.8 |
| Total Medicare Allowed Amount | 85660.4 |
| Total Medicare Payment Amount | 62012.93 |
| Total Medicare Standardized Payment Amount | 60616.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 96 |
| Number Of Medicare Beneficiaries With Drug Services | 84 |
| Total Drug Submitted ChargeAmount | 6269.02 |
| Total Drug Medicare AllowedAmount | 4408.86 |
| Total Drug Medicare PaymentAmount | 4137.82 |
| Total Drug Medicare Standardized Payment Amount | 4137.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 915 |
| Number Of Medicare Beneficiaries With Medical Services | 206 |
| Total Medical Submitted Charge Amount | 181483.78 |
| Total Medical Medicare Allowed Amount | 81251.54 |
| Total Medical Medicare Payment Amount | 57875.11 |
| Total Medical Medicare Standardized Payment Amount | 56478.25 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 113 |
| Number Of Beneficiaries Age 75 to 84 | 67 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 159 |
| Number Of Male Beneficiaries | 47 |
| Number Of Non Hispanic White Beneficiaries | 195 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 195 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 28 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 14 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8512 |