| National Provider Identifier [NPI]: | 1437111622 |
| Last Name Of The Provider | JACKMAN |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4660 KENMORE AVE |
| Street Address 2 Of The Provider | #1200 |
| City Of The Provider | ALEXANDRIA |
| Zip Code Of The Provider | 223041313 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 4188 |
| Number Of Medicare Beneficiaries | 1881 |
| Total Submitted Charge Amount | 840599.06 |
| Total Medicare Allowed Amount | 398480.74 |
| Total Medicare Payment Amount | 295757.98 |
| Total Medicare Standardized Payment Amount | 265133.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 391 |
| Number Of Medicare Beneficiaries With Drug Services | 99 |
| Total Drug Submitted ChargeAmount | 20228.06 |
| Total Drug Medicare AllowedAmount | 20104.41 |
| Total Drug Medicare PaymentAmount | 14722.28 |
| Total Drug Medicare Standardized Payment Amount | 14722.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 3797 |
| Number Of Medicare Beneficiaries With Medical Services | 1881 |
| Total Medical Submitted Charge Amount | 820371 |
| Total Medical Medicare Allowed Amount | 378376.33 |
| Total Medical Medicare Payment Amount | 281035.7 |
| Total Medical Medicare Standardized Payment Amount | 250410.89 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 158 |
| Number Of Beneficiaries Age 65 to 74 | 636 |
| Number Of Beneficiaries Age 75 to 84 | 611 |
| Number Of Beneficiaries Age Greater 84 | 476 |
| Number Of Female Beneficiaries | 989 |
| Number Of Male Beneficiaries | 892 |
| Number Of Non Hispanic White Beneficiaries | 1347 |
| Number Of Black or African American Beneficiaries | 284 |
| Number Of AsianPacific Islander Beneficiaries | 112 |
| Number Of Hispanic Beneficiaries | 102 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1542 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 339 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.7819 |