| National Provider Identifier [NPI]: | 1164786273 |
| Last Name Of The Provider | JASPER |
| First Name Of The Provider | MICHELLE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6751 ABRAMS RD. |
| Street Address 2 Of The Provider | SUITE 108 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 75231 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 342 |
| Number Of Medicare Beneficiaries | 31 |
| Total Submitted Charge Amount | 22350 |
| Total Medicare Allowed Amount | 8688.54 |
| Total Medicare Payment Amount | 7091.18 |
| Total Medicare Standardized Payment Amount | 7844.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 116 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 922 |
| Total Drug Medicare AllowedAmount | 87.33 |
| Total Drug Medicare PaymentAmount | 67.5 |
| Total Drug Medicare Standardized Payment Amount | 67.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 226 |
| Number Of Medicare Beneficiaries With Medical Services | 31 |
| Total Medical Submitted Charge Amount | 21428 |
| Total Medical Medicare Allowed Amount | 8601.21 |
| Total Medical Medicare Payment Amount | 7023.68 |
| Total Medical Medicare Standardized Payment Amount | 7776.7 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | 0 |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1085 |