| National Provider Identifier [NPI]: | 1508851411 |
| Last Name Of The Provider | JACKOWITZ |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3640 MAIN ST |
| Street Address 2 Of The Provider | SUITE 205 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 011071145 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 3536 |
| Number Of Medicare Beneficiaries | 1826 |
| Total Submitted Charge Amount | 582085 |
| Total Medicare Allowed Amount | 349074.07 |
| Total Medicare Payment Amount | 237968.19 |
| Total Medicare Standardized Payment Amount | 232331.46 |
| 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 | 25 |
| Number Of Medical Services | 3536 |
| Number Of Medicare Beneficiaries With Medical Services | 1826 |
| Total Medical Submitted Charge Amount | 582085 |
| Total Medical Medicare Allowed Amount | 349074.07 |
| Total Medical Medicare Payment Amount | 237968.19 |
| Total Medical Medicare Standardized Payment Amount | 232331.46 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 651 |
| Number Of Beneficiaries Age 75 to 84 | 643 |
| Number Of Beneficiaries Age Greater 84 | 471 |
| Number Of Female Beneficiaries | 1168 |
| Number Of Male Beneficiaries | 658 |
| Number Of Non Hispanic White Beneficiaries | 1720 |
| Number Of Black or African American Beneficiaries | 54 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1698 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 128 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0956 |