| National Provider Identifier [NPI]: | 1902958986 |
| Last Name Of The Provider | ACKERMAN |
| First Name Of The Provider | JENNIFER |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 555 HOSPITAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | WARRENTON |
| Zip Code Of The Provider | 201863028 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 1229 |
| Number Of Medicare Beneficiaries | 221 |
| Total Submitted Charge Amount | 186523.4 |
| Total Medicare Allowed Amount | 86756.71 |
| Total Medicare Payment Amount | 63949.45 |
| Total Medicare Standardized Payment Amount | 66056.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 136 |
| Number Of Medicare Beneficiaries With Drug Services | 116 |
| Total Drug Submitted ChargeAmount | 6387 |
| Total Drug Medicare AllowedAmount | 3785.67 |
| Total Drug Medicare PaymentAmount | 3709.73 |
| Total Drug Medicare Standardized Payment Amount | 3709.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 1093 |
| Number Of Medicare Beneficiaries With Medical Services | 221 |
| Total Medical Submitted Charge Amount | 180136.4 |
| Total Medical Medicare Allowed Amount | 82971.04 |
| Total Medical Medicare Payment Amount | 60239.72 |
| Total Medical Medicare Standardized Payment Amount | 62346.64 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 121 |
| Number Of Beneficiaries Age 75 to 84 | 62 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 200 |
| Number Of Male Beneficiaries | 21 |
| Number Of Non Hispanic White Beneficiaries | 198 |
| 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 | 207 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8727 |