| National Provider Identifier [NPI]: | 1144391525 |
| Last Name Of The Provider | JACKSON |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1600 SW ARCHER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GAINESVILLE |
| Zip Code Of The Provider | 326103003 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 1961 |
| Number Of Medicare Beneficiaries | 1580 |
| Total Submitted Charge Amount | 1957080 |
| Total Medicare Allowed Amount | 287307.97 |
| Total Medicare Payment Amount | 217123.43 |
| Total Medicare Standardized Payment Amount | 222071.43 |
| 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 | 49 |
| Number Of Medical Services | 1961 |
| Number Of Medicare Beneficiaries With Medical Services | 1580 |
| Total Medical Submitted Charge Amount | 1957080 |
| Total Medical Medicare Allowed Amount | 287307.97 |
| Total Medical Medicare Payment Amount | 217123.43 |
| Total Medical Medicare Standardized Payment Amount | 222071.43 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 571 |
| Number Of Beneficiaries Age 65 to 74 | 453 |
| Number Of Beneficiaries Age 75 to 84 | 356 |
| Number Of Beneficiaries Age Greater 84 | 200 |
| Number Of Female Beneficiaries | 903 |
| Number Of Male Beneficiaries | 677 |
| Number Of Non Hispanic White Beneficiaries | 983 |
| Number Of Black or African American Beneficiaries | 552 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 825 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 755 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.9882 |