| National Provider Identifier [NPI]: | 1578721882 |
| Last Name Of The Provider | MUELLER |
| First Name Of The Provider | JESSIE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 309 LAKE RD |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | BELTON |
| Zip Code Of The Provider | 765131513 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 1021 |
| Number Of Medicare Beneficiaries | 394 |
| Total Submitted Charge Amount | 82010.03 |
| Total Medicare Allowed Amount | 35667.38 |
| Total Medicare Payment Amount | 23213.79 |
| Total Medicare Standardized Payment Amount | 24910.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 394 |
| Number Of Medicare Beneficiaries With Drug Services | 90 |
| Total Drug Submitted ChargeAmount | 6582.03 |
| Total Drug Medicare AllowedAmount | 476.28 |
| Total Drug Medicare PaymentAmount | 324.9 |
| Total Drug Medicare Standardized Payment Amount | 324.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 627 |
| Number Of Medicare Beneficiaries With Medical Services | 394 |
| Total Medical Submitted Charge Amount | 75428 |
| Total Medical Medicare Allowed Amount | 35191.1 |
| Total Medical Medicare Payment Amount | 22888.89 |
| Total Medical Medicare Standardized Payment Amount | 24585.34 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 89 |
| Number Of Beneficiaries Age 65 to 74 | 188 |
| Number Of Beneficiaries Age 75 to 84 | 97 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 263 |
| Number Of Male Beneficiaries | 131 |
| Number Of Non Hispanic White Beneficiaries | 336 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 307 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 87 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0662 |