| National Provider Identifier [NPI]: | 1225165590 |
| Last Name Of The Provider | MARSHAK |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | O.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 390 N SEPULVEDA BLVD |
| Street Address 2 Of The Provider | SUITE# 1100 |
| City Of The Provider | EL SEGUNDO |
| Zip Code Of The Provider | 902454475 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 4 |
| Number Of Services | 1315 |
| Number Of Medicare Beneficiaries | 1299 |
| Total Submitted Charge Amount | 221029 |
| Total Medicare Allowed Amount | 181814.33 |
| Total Medicare Payment Amount | 140966.96 |
| Total Medicare Standardized Payment Amount | 131933.62 |
| 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 | 4 |
| Number Of Medical Services | 1315 |
| Number Of Medicare Beneficiaries With Medical Services | 1299 |
| Total Medical Submitted Charge Amount | 221029 |
| Total Medical Medicare Allowed Amount | 181814.33 |
| Total Medical Medicare Payment Amount | 140966.96 |
| Total Medical Medicare Standardized Payment Amount | 131933.62 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 162 |
| Number Of Beneficiaries Age 65 to 74 | 269 |
| Number Of Beneficiaries Age 75 to 84 | 373 |
| Number Of Beneficiaries Age Greater 84 | 495 |
| Number Of Female Beneficiaries | 842 |
| Number Of Male Beneficiaries | 457 |
| Number Of Non Hispanic White Beneficiaries | 761 |
| Number Of Black or African American Beneficiaries | 108 |
| Number Of AsianPacific Islander Beneficiaries | 54 |
| Number Of Hispanic Beneficiaries | 352 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 199 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1100 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 66 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 20 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.4879 |