| National Provider Identifier [NPI]: | 1831206127 |
| Last Name Of The Provider | SCHMITT |
| First Name Of The Provider | JILL |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2414 KOHLER MEMORIAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHEBOYGAN |
| Zip Code Of The Provider | 53081 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 1924 |
| Number Of Medicare Beneficiaries | 361 |
| Total Submitted Charge Amount | 268186.99 |
| Total Medicare Allowed Amount | 81755.28 |
| Total Medicare Payment Amount | 58932.49 |
| Total Medicare Standardized Payment Amount | 62723.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 178 |
| Number Of Medicare Beneficiaries With Drug Services | 84 |
| Total Drug Submitted ChargeAmount | 6175.99 |
| Total Drug Medicare AllowedAmount | 3376.87 |
| Total Drug Medicare PaymentAmount | 3033.4 |
| Total Drug Medicare Standardized Payment Amount | 3033.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 1746 |
| Number Of Medicare Beneficiaries With Medical Services | 361 |
| Total Medical Submitted Charge Amount | 262011 |
| Total Medical Medicare Allowed Amount | 78378.41 |
| Total Medical Medicare Payment Amount | 55899.09 |
| Total Medical Medicare Standardized Payment Amount | 59689.78 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 175 |
| Number Of Beneficiaries Age 75 to 84 | 94 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 280 |
| Number Of Male Beneficiaries | 81 |
| Number Of Non Hispanic White Beneficiaries | 342 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 298 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 0.9796 |