| National Provider Identifier [NPI]: | 1962403188 |
| Last Name Of The Provider | SACKS |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3725 11TH CR |
| Street Address 2 Of The Provider | |
| City Of The Provider | VERO BEACH |
| Zip Code Of The Provider | 329604804 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 171 |
| Number Of Services | 14930 |
| Number Of Medicare Beneficiaries | 3979 |
| Total Submitted Charge Amount | 1514343.31 |
| Total Medicare Allowed Amount | 678968.93 |
| Total Medicare Payment Amount | 528034.39 |
| Total Medicare Standardized Payment Amount | 515693.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 8976 |
| Number Of Medicare Beneficiaries With Drug Services | 313 |
| Total Drug Submitted ChargeAmount | 14578.92 |
| Total Drug Medicare AllowedAmount | 5085.2 |
| Total Drug Medicare PaymentAmount | 3971.42 |
| Total Drug Medicare Standardized Payment Amount | 3971.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 165 |
| Number Of Medical Services | 5954 |
| Number Of Medicare Beneficiaries With Medical Services | 3977 |
| Total Medical Submitted Charge Amount | 1499764.39 |
| Total Medical Medicare Allowed Amount | 673883.73 |
| Total Medical Medicare Payment Amount | 524062.97 |
| Total Medical Medicare Standardized Payment Amount | 511722.49 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 369 |
| Number Of Beneficiaries Age 65 to 74 | 1354 |
| Number Of Beneficiaries Age 75 to 84 | 1408 |
| Number Of Beneficiaries Age Greater 84 | 848 |
| Number Of Female Beneficiaries | 2352 |
| Number Of Male Beneficiaries | 1627 |
| Number Of Non Hispanic White Beneficiaries | 3706 |
| Number Of Black or African American Beneficiaries | 141 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 82 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3516 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 463 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4665 |