| National Provider Identifier [NPI]: | 1487639761 |
| Last Name Of The Provider | MEYER |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1800 LAWRENCE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | DE PERE |
| Zip Code Of The Provider | 541159108 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 839 |
| Number Of Medicare Beneficiaries | 170 |
| Total Submitted Charge Amount | 92626 |
| Total Medicare Allowed Amount | 28616.2 |
| Total Medicare Payment Amount | 22770.63 |
| Total Medicare Standardized Payment Amount | 24050.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 37 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 1228 |
| Total Drug Medicare AllowedAmount | 1002.42 |
| Total Drug Medicare PaymentAmount | 981.75 |
| Total Drug Medicare Standardized Payment Amount | 981.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 802 |
| Number Of Medicare Beneficiaries With Medical Services | 170 |
| Total Medical Submitted Charge Amount | 91398 |
| Total Medical Medicare Allowed Amount | 27613.78 |
| Total Medical Medicare Payment Amount | 21788.88 |
| Total Medical Medicare Standardized Payment Amount | 23068.86 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 86 |
| Number Of Beneficiaries Age 75 to 84 | 45 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 80 |
| Number Of Male Beneficiaries | 90 |
| Number Of Non Hispanic White Beneficiaries | 155 |
| 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 | 147 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.024 |