| National Provider Identifier [NPI]: | 1538165386 |
| Last Name Of The Provider | JACKSON |
| First Name Of The Provider | EUGENE |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 118 NORMAN DORMINY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | FITZGERALD |
| Zip Code Of The Provider | 317508858 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 107 |
| Number Of Services | 4876 |
| Number Of Medicare Beneficiaries | 771 |
| Total Submitted Charge Amount | 271117 |
| Total Medicare Allowed Amount | 139242.39 |
| Total Medicare Payment Amount | 88345.79 |
| Total Medicare Standardized Payment Amount | 99729.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 23 |
| Number Of Drug Services | 2645 |
| Number Of Medicare Beneficiaries With Drug Services | 312 |
| Total Drug Submitted ChargeAmount | 41654 |
| Total Drug Medicare AllowedAmount | 3183.01 |
| Total Drug Medicare PaymentAmount | 2189.47 |
| Total Drug Medicare Standardized Payment Amount | 2189.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 2231 |
| Number Of Medicare Beneficiaries With Medical Services | 771 |
| Total Medical Submitted Charge Amount | 229463 |
| Total Medical Medicare Allowed Amount | 136059.38 |
| Total Medical Medicare Payment Amount | 86156.32 |
| Total Medical Medicare Standardized Payment Amount | 97539.68 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 135 |
| Number Of Beneficiaries Age 65 to 74 | 388 |
| Number Of Beneficiaries Age 75 to 84 | 202 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 478 |
| Number Of Male Beneficiaries | 293 |
| Number Of Non Hispanic White Beneficiaries | 693 |
| Number Of Black or African American Beneficiaries | 62 |
| 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 | 694 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 77 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9438 |