| National Provider Identifier [NPI]: | 1114976131 |
| Last Name Of The Provider | MISSLBECK |
| First Name Of The Provider | JAMES |
| 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 | 600 COFFEE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MODESTO |
| Zip Code Of The Provider | 953554201 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 13233 |
| Number Of Medicare Beneficiaries | 608 |
| Total Submitted Charge Amount | 1000424.25 |
| Total Medicare Allowed Amount | 428305.23 |
| Total Medicare Payment Amount | 327027.56 |
| Total Medicare Standardized Payment Amount | 322205.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 31 |
| Number Of Drug Services | 11674 |
| Number Of Medicare Beneficiaries With Drug Services | 238 |
| Total Drug Submitted ChargeAmount | 706177.85 |
| Total Drug Medicare AllowedAmount | 322444.14 |
| Total Drug Medicare PaymentAmount | 252191.36 |
| Total Drug Medicare Standardized Payment Amount | 252191.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 1559 |
| Number Of Medicare Beneficiaries With Medical Services | 608 |
| Total Medical Submitted Charge Amount | 294246.4 |
| Total Medical Medicare Allowed Amount | 105861.09 |
| Total Medical Medicare Payment Amount | 74836.2 |
| Total Medical Medicare Standardized Payment Amount | 70014.04 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 158 |
| Number Of Beneficiaries Age 65 to 74 | 229 |
| Number Of Beneficiaries Age 75 to 84 | 161 |
| Number Of Beneficiaries Age Greater 84 | 60 |
| Number Of Female Beneficiaries | 414 |
| Number Of Male Beneficiaries | 194 |
| Number Of Non Hispanic White Beneficiaries | 457 |
| Number Of Black or African American Beneficiaries | 25 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 105 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 404 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 204 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2355 |