| National Provider Identifier [NPI]: | 1467418111 |
| Last Name Of The Provider | JACOBS |
| First Name Of The Provider | STUART |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 305 HOSPITAL DR |
| Street Address 2 Of The Provider | SUITE 305 TATE CENTER |
| City Of The Provider | GLEN BURNIE |
| Zip Code Of The Provider | 210615805 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 1568 |
| Number Of Medicare Beneficiaries | 355 |
| Total Submitted Charge Amount | 200979 |
| Total Medicare Allowed Amount | 179854.32 |
| Total Medicare Payment Amount | 139605.63 |
| Total Medicare Standardized Payment Amount | 132529.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 21 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 1175 |
| Total Drug Medicare AllowedAmount | 873.86 |
| Total Drug Medicare PaymentAmount | 856.35 |
| Total Drug Medicare Standardized Payment Amount | 856.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 1547 |
| Number Of Medicare Beneficiaries With Medical Services | 355 |
| Total Medical Submitted Charge Amount | 199804 |
| Total Medical Medicare Allowed Amount | 178980.46 |
| Total Medical Medicare Payment Amount | 138749.28 |
| Total Medical Medicare Standardized Payment Amount | 131672.66 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 133 |
| Number Of Beneficiaries Age 75 to 84 | 119 |
| Number Of Beneficiaries Age Greater 84 | 52 |
| Number Of Female Beneficiaries | 196 |
| Number Of Male Beneficiaries | 159 |
| Number Of Non Hispanic White Beneficiaries | 318 |
| Number Of Black or African American Beneficiaries | |
| 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 | 305 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 50 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 21 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 65 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.2596 |