| National Provider Identifier [NPI]: | 1073573887 |
| Last Name Of The Provider | MEILAHN |
| First Name Of The Provider | JILL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 N OAK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MARSHFIELD |
| Zip Code Of The Provider | 544495703 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 4662 |
| Number Of Medicare Beneficiaries | 57 |
| Total Submitted Charge Amount | 172041.9 |
| Total Medicare Allowed Amount | 43884.04 |
| Total Medicare Payment Amount | 32668.29 |
| Total Medicare Standardized Payment Amount | 32951.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 4524 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 73213.6 |
| Total Drug Medicare AllowedAmount | 30331.75 |
| Total Drug Medicare PaymentAmount | 22654.37 |
| Total Drug Medicare Standardized Payment Amount | 22654.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 138 |
| Number Of Medicare Beneficiaries With Medical Services | 57 |
| Total Medical Submitted Charge Amount | 98828.3 |
| Total Medical Medicare Allowed Amount | 13552.29 |
| Total Medical Medicare Payment Amount | 10013.92 |
| Total Medical Medicare Standardized Payment Amount | 10297.16 |
| Average Age Of Beneficiaries | 47 |
| Number Of Beneficiaries Age Less65 | 45 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 30 |
| Number Of Male Beneficiaries | 27 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 0 |
| 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 | 25 |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 19 |
| Percent Of With Hypertension | 30 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 1.3452 |