| National Provider Identifier [NPI]: | 1013910298 |
| Last Name Of The Provider | SCHELLHASE |
| First Name Of The Provider | JILL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1781 COUNTRYSIDE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | LANCASTER |
| Zip Code Of The Provider | 431301186 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 451 |
| Number Of Medicare Beneficiaries | 98 |
| Total Submitted Charge Amount | 46671.44 |
| Total Medicare Allowed Amount | 32086.88 |
| Total Medicare Payment Amount | 21467.64 |
| Total Medicare Standardized Payment Amount | 23076.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 23 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 942.44 |
| Total Drug Medicare AllowedAmount | 847.85 |
| Total Drug Medicare PaymentAmount | 825.21 |
| Total Drug Medicare Standardized Payment Amount | 825.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 428 |
| Number Of Medicare Beneficiaries With Medical Services | 98 |
| Total Medical Submitted Charge Amount | 45729 |
| Total Medical Medicare Allowed Amount | 31239.03 |
| Total Medical Medicare Payment Amount | 20642.43 |
| Total Medical Medicare Standardized Payment Amount | 22250.86 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 37 |
| Number Of Beneficiaries Age 75 to 84 | 22 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 63 |
| Number Of Male Beneficiaries | 35 |
| 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 | 64 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3545 |