| National Provider Identifier [NPI]: | 1427303221 |
| Last Name Of The Provider | RETTERATH |
| First Name Of The Provider | JILL |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2199 HIGHWAY 36 E |
| Street Address 2 Of The Provider | |
| City Of The Provider | NORTH SAINT PAUL |
| Zip Code Of The Provider | 551092215 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 146 |
| Number Of Medicare Beneficiaries | 71 |
| Total Submitted Charge Amount | 24081.9 |
| Total Medicare Allowed Amount | 10622.07 |
| Total Medicare Payment Amount | 7956.35 |
| Total Medicare Standardized Payment Amount | 9744.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 13 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 446.9 |
| Total Drug Medicare AllowedAmount | 432.32 |
| Total Drug Medicare PaymentAmount | 358.25 |
| Total Drug Medicare Standardized Payment Amount | 358.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 133 |
| Number Of Medicare Beneficiaries With Medical Services | 70 |
| Total Medical Submitted Charge Amount | 23635 |
| Total Medical Medicare Allowed Amount | 10189.75 |
| Total Medical Medicare Payment Amount | 7598.1 |
| Total Medical Medicare Standardized Payment Amount | 9386.35 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 21 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 38 |
| Number Of Male Beneficiaries | 33 |
| Number Of Non Hispanic White Beneficiaries | 39 |
| 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 | 23 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4483 |