| National Provider Identifier [NPI]: | 1376618926 |
| Last Name Of The Provider | MUJICA |
| First Name Of The Provider | JORGE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1133 EAGLES LANDING PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | STOCKBRIDGE |
| Zip Code Of The Provider | 302815085 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 1044 |
| Number Of Medicare Beneficiaries | 697 |
| Total Submitted Charge Amount | 1229557 |
| Total Medicare Allowed Amount | 125641.06 |
| Total Medicare Payment Amount | 97285.47 |
| Total Medicare Standardized Payment Amount | 91908.36 |
| 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 | 27 |
| Number Of Medical Services | 1044 |
| Number Of Medicare Beneficiaries With Medical Services | 697 |
| Total Medical Submitted Charge Amount | 1229557 |
| Total Medical Medicare Allowed Amount | 125641.06 |
| Total Medical Medicare Payment Amount | 97285.47 |
| Total Medical Medicare Standardized Payment Amount | 91908.36 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 82 |
| Number Of Beneficiaries Age 65 to 74 | 243 |
| Number Of Beneficiaries Age 75 to 84 | 237 |
| Number Of Beneficiaries Age Greater 84 | 135 |
| Number Of Female Beneficiaries | 369 |
| Number Of Male Beneficiaries | 328 |
| Number Of Non Hispanic White Beneficiaries | 616 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 53 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 587 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 110 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.458 |