| National Provider Identifier [NPI]: | 1275533143 |
| Last Name Of The Provider | MUSGRAVE |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 212 W DALE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WATERLOO |
| Zip Code Of The Provider | 507031951 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 1498 |
| Number Of Medicare Beneficiaries | 247 |
| Total Submitted Charge Amount | 98292 |
| Total Medicare Allowed Amount | 70388.42 |
| Total Medicare Payment Amount | 52646.67 |
| Total Medicare Standardized Payment Amount | 57834.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 135 |
| Number Of Medicare Beneficiaries With Drug Services | 105 |
| Total Drug Submitted ChargeAmount | 6810 |
| Total Drug Medicare AllowedAmount | 4826.67 |
| Total Drug Medicare PaymentAmount | 4724.65 |
| Total Drug Medicare Standardized Payment Amount | 4724.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 1363 |
| Number Of Medicare Beneficiaries With Medical Services | 247 |
| Total Medical Submitted Charge Amount | 91482 |
| Total Medical Medicare Allowed Amount | 65561.75 |
| Total Medical Medicare Payment Amount | 47922.02 |
| Total Medical Medicare Standardized Payment Amount | 53109.41 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 133 |
| Number Of Beneficiaries Age 75 to 84 | 66 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 123 |
| Number Of Male Beneficiaries | 124 |
| Number Of Non Hispanic White Beneficiaries | 225 |
| 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 | 223 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 7 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8041 |