| National Provider Identifier [NPI]: | 1427038280 |
| Last Name Of The Provider | JACKERSON |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 640 S STATE STREET |
| Street Address 2 Of The Provider | DEPT OF RADIOLOGY |
| City Of The Provider | DOVER |
| Zip Code Of The Provider | 199013530 |
| State Code Of The Provider | DE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 221 |
| Number Of Services | 11473 |
| Number Of Medicare Beneficiaries | 6029 |
| Total Submitted Charge Amount | 1111041 |
| Total Medicare Allowed Amount | 264714.08 |
| Total Medicare Payment Amount | 202634.68 |
| Total Medicare Standardized Payment Amount | 201535.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 221 |
| Number Of Medical Services | 11473 |
| Number Of Medicare Beneficiaries With Medical Services | 6029 |
| Total Medical Submitted Charge Amount | 1111041 |
| Total Medical Medicare Allowed Amount | 264714.08 |
| Total Medical Medicare Payment Amount | 202634.68 |
| Total Medical Medicare Standardized Payment Amount | 201535.66 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 980 |
| Number Of Beneficiaries Age 65 to 74 | 2531 |
| Number Of Beneficiaries Age 75 to 84 | 1752 |
| Number Of Beneficiaries Age Greater 84 | 766 |
| Number Of Female Beneficiaries | 3743 |
| Number Of Male Beneficiaries | 2286 |
| Number Of Non Hispanic White Beneficiaries | 4809 |
| Number Of Black or African American Beneficiaries | 1012 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 113 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 47 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4602 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1427 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5599 |