Medicare Facts for Dr. Walter C. Jackson, DDS


National Provider Identifier [NPI]: 1902982796
Last Name Of The Provider JACKSON
First Name Of The Provider WALTER
Middle Initial Of The Provider O
Credentials Of The Provider MD
Gender Of The Provider M
Entity Type Of The Provider I
Street Address 1 Of The Provider 10329 GREENOAK BLVD
Street Address 2 Of The Provider
City Of The Provider FORT WAYNE
Zip Code Of The Provider 468149546
State Code Of The Provider IN
Country Code Of The Provider US
Provider Type Of The Provider Emergency Medicine
Medicare Participation Indicator Y
Number Of HCPCS 20
Number Of Services 648
Number Of Medicare Beneficiaries 414
Total Submitted Charge Amount 153987
Total Medicare Allowed Amount 59413.3
Total Medicare Payment Amount 44743.69
Total Medicare Standardized Payment Amount 45916.62
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 20
Number Of Medical Services 648
Number Of Medicare Beneficiaries With Medical Services 414
Total Medical Submitted Charge Amount 153987
Total Medical Medicare Allowed Amount 59413.3
Total Medical Medicare Payment Amount 44743.69
Total Medical Medicare Standardized Payment Amount 45916.62
Average Age Of Beneficiaries 69
Number Of Beneficiaries Age Less65 126
Number Of Beneficiaries Age 65 to 74 105
Number Of Beneficiaries Age 75 to 84 112
Number Of Beneficiaries Age Greater 84 71
Number Of Female Beneficiaries 217
Number Of Male Beneficiaries 197
Number Of Non Hispanic White Beneficiaries 313
Number Of Black or African American Beneficiaries
Number Of AsianPacific Islander Beneficiaries
Number Of Hispanic Beneficiaries 46
Number Of American Indian Alaska Native Beneficiaries 41
Number Of Beneficiaries With Race Not Else where Classified
Number Of Beneficiaries With Medicare Only Entitlement 247
Number Of Beneficiaries With Medicare Medicaid Entitlement 167
Percent Of With Atrial Fibrillation 16
Percent Of With Alzheimers Disease or Dementia 16
Percent Of With Asthma 12
Percent Of With Cancer 11
Percent Of With Heart Failure 38
Percent Of With Chronic Kidney Disease 43
Percent Of With Chronic Obstructive Pulmonary Disease 26
Percent Of With Depression 38
Percent Of With Diabetes 40
Percent Of With Hyperlipidemia 55
Percent Of With Hypertension 73
Percent Of With Ischemic Heart Disease 54
Percent Of With Osteoporosis 12
Percent Of With Rheumatoid Arthritis Osteoarthritis 37
Percent Of With Schizophrenia Other PsychoticDisorders 14
Percent Of With Stroke 8
Average HCC Risk Score Of Beneficiaries 2.2276

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