| National Provider Identifier [NPI]: | 1942407135 |
| Last Name Of The Provider | JABLONSKI |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1675 E MAIN ST |
| Street Address 2 Of The Provider | BOX 328 |
| City Of The Provider | KENT |
| Zip Code Of The Provider | 442405818 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 169 |
| Number Of Services | 6258 |
| Number Of Medicare Beneficiaries | 4940 |
| Total Submitted Charge Amount | 702176.82 |
| Total Medicare Allowed Amount | 209019.87 |
| Total Medicare Payment Amount | 152808.86 |
| Total Medicare Standardized Payment Amount | 157469.73 |
| 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 | 169 |
| Number Of Medical Services | 6258 |
| Number Of Medicare Beneficiaries With Medical Services | 4940 |
| Total Medical Submitted Charge Amount | 702176.82 |
| Total Medical Medicare Allowed Amount | 209019.87 |
| Total Medical Medicare Payment Amount | 152808.86 |
| Total Medical Medicare Standardized Payment Amount | 157469.73 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 1198 |
| Number Of Beneficiaries Age 65 to 74 | 1425 |
| Number Of Beneficiaries Age 75 to 84 | 1283 |
| Number Of Beneficiaries Age Greater 84 | 1034 |
| Number Of Female Beneficiaries | 2981 |
| Number Of Male Beneficiaries | 1959 |
| Number Of Non Hispanic White Beneficiaries | 4454 |
| Number Of Black or African American Beneficiaries | 359 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 70 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3149 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1791 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8254 |