| National Provider Identifier [NPI]: | 1134185945 |
| Last Name Of The Provider | STILLWELL |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1703 N TAYLOR DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHEBOYGAN |
| Zip Code Of The Provider | 530811933 |
| 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 | 152 |
| Number Of Services | 3219 |
| Number Of Medicare Beneficiaries | 425 |
| Total Submitted Charge Amount | 309387 |
| Total Medicare Allowed Amount | 106612.26 |
| Total Medicare Payment Amount | 78520.04 |
| Total Medicare Standardized Payment Amount | 81200.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 424 |
| Number Of Medicare Beneficiaries With Drug Services | 100 |
| Total Drug Submitted ChargeAmount | 7334 |
| Total Drug Medicare AllowedAmount | 3667.38 |
| Total Drug Medicare PaymentAmount | 3528.37 |
| Total Drug Medicare Standardized Payment Amount | 3528.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 142 |
| Number Of Medical Services | 2795 |
| Number Of Medicare Beneficiaries With Medical Services | 425 |
| Total Medical Submitted Charge Amount | 302053 |
| Total Medical Medicare Allowed Amount | 102944.88 |
| Total Medical Medicare Payment Amount | 74991.67 |
| Total Medical Medicare Standardized Payment Amount | 77672.02 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 148 |
| Number Of Beneficiaries Age 75 to 84 | 145 |
| Number Of Beneficiaries Age Greater 84 | 81 |
| Number Of Female Beneficiaries | 219 |
| Number Of Male Beneficiaries | 206 |
| Number Of Non Hispanic White Beneficiaries | 402 |
| 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 | 350 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9907 |