Medicare Facts for Dr. Lori R. Jackson, MD


National Provider Identifier [NPI]: 1154533271
Last Name Of The Provider JACKSON
First Name Of The Provider LORI
Middle Initial Of The Provider
Credentials Of The Provider MD
Gender Of The Provider F
Entity Type Of The Provider I
Street Address 1 Of The Provider 250 WEST KENWOOD
Street Address 2 Of The Provider
City Of The Provider DECATUR
Zip Code Of The Provider 62526
State Code Of The Provider IL
Country Code Of The Provider US
Provider Type Of The Provider Family Practice
Medicare Participation Indicator Y
Number Of HCPCS 14
Number Of Services 238
Number Of Medicare Beneficiaries 100
Total Submitted Charge Amount 28895
Total Medicare Allowed Amount 18173.18
Total Medicare Payment Amount 13178.89
Total Medicare Standardized Payment Amount 12903.56
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 14
Number Of Medical Services 238
Number Of Medicare Beneficiaries With Medical Services 100
Total Medical Submitted Charge Amount 28895
Total Medical Medicare Allowed Amount 18173.18
Total Medical Medicare Payment Amount 13178.89
Total Medical Medicare Standardized Payment Amount 12903.56
Average Age Of Beneficiaries 70
Number Of Beneficiaries Age Less65
Number Of Beneficiaries Age 65 to 74 51
Number Of Beneficiaries Age 75 to 84 21
Number Of Beneficiaries Age Greater 84
Number Of Female Beneficiaries 72
Number Of Male Beneficiaries 28
Number Of Non Hispanic White Beneficiaries 80
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 86
Number Of Beneficiaries With Medicare Medicaid Entitlement 14
Percent Of With Atrial Fibrillation
Percent Of With Alzheimers Disease or Dementia
Percent Of With Asthma 11
Percent Of With Cancer
Percent Of With Heart Failure
Percent Of With Chronic Kidney Disease 11
Percent Of With Chronic Obstructive Pulmonary Disease
Percent Of With Depression 18
Percent Of With Diabetes 22
Percent Of With Hyperlipidemia 27
Percent Of With Hypertension 41
Percent Of With Ischemic Heart Disease 22
Percent Of With Osteoporosis
Percent Of With Rheumatoid Arthritis Osteoarthritis 35
Percent Of With Schizophrenia Other PsychoticDisorders
Percent Of With Stroke
Average HCC Risk Score Of Beneficiaries 0.917

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