| National Provider Identifier [NPI]: | 1033123179 |
| Last Name Of The Provider | JACKSON |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 1ST ST SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCHESTER |
| Zip Code Of The Provider | 559050001 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 985 |
| Number Of Medicare Beneficiaries | 220 |
| Total Submitted Charge Amount | 345233.94 |
| Total Medicare Allowed Amount | 149303.1 |
| Total Medicare Payment Amount | 110013.17 |
| Total Medicare Standardized Payment Amount | 120260.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 197 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 3690 |
| Total Drug Medicare AllowedAmount | 2077.59 |
| Total Drug Medicare PaymentAmount | 1608.35 |
| Total Drug Medicare Standardized Payment Amount | 1608.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 788 |
| Number Of Medicare Beneficiaries With Medical Services | 220 |
| Total Medical Submitted Charge Amount | 341543.94 |
| Total Medical Medicare Allowed Amount | 147225.51 |
| Total Medical Medicare Payment Amount | 108404.82 |
| Total Medical Medicare Standardized Payment Amount | 118652.56 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 96 |
| Number Of Beneficiaries Age 75 to 84 | 66 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 148 |
| Number Of Male Beneficiaries | 72 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1576 |