| National Provider Identifier [NPI]: | 1083689855 |
| Last Name Of The Provider | JACKSON |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 MCLAIN |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEWPORT |
| Zip Code Of The Provider | 721123638 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 7338 |
| Number Of Medicare Beneficiaries | 440 |
| Total Submitted Charge Amount | 377720.08 |
| Total Medicare Allowed Amount | 240361.62 |
| Total Medicare Payment Amount | 182945.98 |
| Total Medicare Standardized Payment Amount | 198975.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 878 |
| Number Of Medicare Beneficiaries With Drug Services | 273 |
| Total Drug Submitted ChargeAmount | 10942.58 |
| Total Drug Medicare AllowedAmount | 5489.95 |
| Total Drug Medicare PaymentAmount | 5267.46 |
| Total Drug Medicare Standardized Payment Amount | 5267.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 102 |
| Number Of Medical Services | 6460 |
| Number Of Medicare Beneficiaries With Medical Services | 439 |
| Total Medical Submitted Charge Amount | 366777.5 |
| Total Medical Medicare Allowed Amount | 234871.67 |
| Total Medical Medicare Payment Amount | 177678.52 |
| Total Medical Medicare Standardized Payment Amount | 193707.82 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 105 |
| Number Of Beneficiaries Age 65 to 74 | 180 |
| Number Of Beneficiaries Age 75 to 84 | 98 |
| Number Of Beneficiaries Age Greater 84 | 57 |
| Number Of Female Beneficiaries | 248 |
| Number Of Male Beneficiaries | 192 |
| Number Of Non Hispanic White Beneficiaries | 397 |
| Number Of Black or African American Beneficiaries | |
| 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 | 304 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 136 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0836 |