| National Provider Identifier [NPI]: | 1326266867 |
| Last Name Of The Provider | JAKUBOWSKI |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1670 CLAIRMONT RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DECATUR |
| Zip Code Of The Provider | 300334004 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 183 |
| Number Of Services | 4572 |
| Number Of Medicare Beneficiaries | 3610 |
| Total Submitted Charge Amount | 866907 |
| Total Medicare Allowed Amount | 136349.4 |
| Total Medicare Payment Amount | 102618.29 |
| Total Medicare Standardized Payment Amount | 107210.56 |
| 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 | 183 |
| Number Of Medical Services | 4572 |
| Number Of Medicare Beneficiaries With Medical Services | 3610 |
| Total Medical Submitted Charge Amount | 866907 |
| Total Medical Medicare Allowed Amount | 136349.4 |
| Total Medical Medicare Payment Amount | 102618.29 |
| Total Medical Medicare Standardized Payment Amount | 107210.56 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 666 |
| Number Of Beneficiaries Age 65 to 74 | 1254 |
| Number Of Beneficiaries Age 75 to 84 | 1066 |
| Number Of Beneficiaries Age Greater 84 | 624 |
| Number Of Female Beneficiaries | 2330 |
| Number Of Male Beneficiaries | 1280 |
| Number Of Non Hispanic White Beneficiaries | 2989 |
| Number Of Black or African American Beneficiaries | 388 |
| Number Of AsianPacific Islander Beneficiaries | 31 |
| Number Of Hispanic Beneficiaries | 166 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2682 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 928 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8287 |