JEFFREY R. MCLAUGHLIN M.D.
NPI 1104862010
Orthopaedic Surgery in Oshkosh, WI


Quality Rating: 30 out of 100 score

NPI Status: Active since June 20, 2006

Contact Information

2700 W 9TH AVE
SUITE 125
OSHKOSH, WI
ZIP 54904
Phone: (920) 223-0123
Fax: (920) 223-0370

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  • Individual
  • Male
  • Orthopaedic Surgery
  • Accepts Insurance
  • PECOS Enrolled
  • Medicare Quality Reporting

About JEFFREY MCLAUGHLIN

This page provides the complete NPI Profile along with additional information for Jeffrey Mclaughlin, a provider established in Oshkosh, Wisconsin with a medical specialization in Orthopaedic Surgery. The healthcare provider is registered in the NPI registry with number 1104862010 assigned on June 2006. The practitioner's primary taxonomy code is 207X00000X with license number 33651 (WI). The provider is registered as an individual and his NPI record was last updated 15 years ago.

NPI
1104862010
Provider Name
JEFFREY R. MCLAUGHLIN M.D.
Gender
Male
Entity Type
Individual
Location Address
2700 W 9TH AVE SUITE 125 OSHKOSH, WI 54904
Location Phone
(920) 223-0123
Location Fax
(920) 223-0370
Mailing Address
PO BOX 381 NEENAH, WI 54957
Mailing Phone
(920) 233-0123
Mailing Fax
(920) 223-0370
Is Sole Proprietor?
No
Enumeration Date
06-20-2006
Last Update Date
03-24-2010
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Orthopaedic Surgery

Taxonomy Code
207X00000X
Type
Allopathic & Osteopathic Physicians
License No.
33651
License State
WI
Taxonomy Description
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Gold 1 - HMO
  • Gold 1 with Adult Vision Services - HMO
  • Gold 8 - HMO
  • Silver 1 - HMO
  • Silver 1 with Adult Vision Services - HMO
  • Silver 12 with First 4 Primary Care Visits Free - HMO
  • Silver 8 - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
E78999MEDICARE UPIN (02)WI 
000071393MEDICARE ID-TYPE UNSPECIFIED (04)WI 
31914500MEDICAID (05)WI 

Medicare Participation & PECOS Enrollment Status

Jeffrey Mclaughlin is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE000N)

    Walker, heavy duty, without wheels, rigid or folding, any type, each (HCPCS:E0148)

    1 DME suppliers used 12 Medicare Claims 12 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 96 times for 76 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 90 times for 87 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 31 times for 31 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

This service was performed 874 times for 76 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 25 times for 25 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 65 times for 65 patients

Replacement of knee joint, both sides of knee

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

This service was performed 62 times for 59 patients

Replacement of thigh bone and hip joint with prosthesis

This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.

This service was performed 29 times for 28 patients

X-ray of both hips, 2 views

An X-ray of both hips, 2 views, is an imaging test that uses a small amount of radiation to create detailed pictures of your hip joints. This procedure helps to detect fractures, infections, or other abnormalities in the hip area. Two different angles will be captured for a comprehensive assessment.

This service was performed 17 times for 17 patients

X-ray of both knees while standing

An X-ray of both knees while standing is a diagnostic procedure that captures images of your knee joints. You'll stand in front of an X-ray machine, and it will take pictures showing the bones and tissues in your knees. This helps doctors identify any abnormalities or injuries.

This service was performed 33 times for 33 patients

X-ray of hip, 2-3 views

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

This service was performed 98 times for 80 patients

X-ray of knee, 3 views

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

This service was performed 211 times for 164 patients

X-ray of pelvis, 1-2 views

An X-ray of the pelvis, 1-2 views, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the lower part of your torso. These images help to detect any abnormalities or injuries in your hip bones and surrounding structures.

This service was performed 57 times for 56 patients

X-ray of spine, 1 view

An X-ray of the spine, 1 view, is a quick and painless imaging procedure. It uses radiation to capture images of the bones in your spine. It helps in detecting issues like fractures, infections, or tumors. You'll be positioned, the machine captures the image, and you're done. It's a safe, routine procedure.

This service was performed 28 times for 28 patients

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 54904 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $82.92
  • Minimum New Patient Price $53.9
  • Maximum New Patient Price $163.24
  • Average New Patient Copayment $20.73
  • Minimum New Patient Copayment $13.47
  • Maximum New Patient Copayment $40.81

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $67.37
  • Minimum Established Patient Price $17.4
  • Maximum Established Patient Price $133.76
  • Average Established Patient Copayment $16.84
  • Minimum Established Patient Copayment $4.35
  • Maximum Established Patient Copayment $33.44

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 30, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 30 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 0

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: N/A

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 0

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: 100

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: 100

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Chronic Care and Preventative Care Management for Empaneled PatientsYesN/A
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
e-Prescribing 95% 307
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Implementation of medication management practice improvementsYesN/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Medication Reconciliation 100% 356
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education 40% 991
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Provide Patient Access 50% 990
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging 10% 990
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.
Use of decision support and standardized treatment protocolsYesN/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1104862010
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2104166402
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 0 + 4 + 1 + 6 + 6 + 4 + 0 + 2 + 24 = 50
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1104862010 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1396739488 JAY M GONZALEZ DO
Individual
Obstetrics & Gynecology2700 W 9TH AVE STE 230
OSHKOSH, WI 54904
(920) 223-0220
1104810100 MAMOUN B AL-NOURI MD
Individual
Internal Medicine (Cardiovascular Disease)2700 W 9TH AVE STE 106
OSHKOSH, WI 54904
(920) 236-1755
1740274653 ROY E BUCK MD
Individual
Orthopaedic Surgery2700 W 9TH AVE STE 220
OSHKOSH, WI 54904
(920) 223-2600
1144214909 THERESA M CHENG MD PHD
Individual
Neurological Surgery2700 W 9TH AVE STE 203
OSHKOSH, WI 54904
(920) 236-1420
1922092584 ROBERT S MCDONALD MD
Individual
Surgery2700 W 9TH AVE STE 310
OSHKOSH, WI 54904
(920) 223-3550
1629063144 MICHAEL J FOLEY MD
Individual
Surgery2700 W 9TH AVE STE 310
OSHKOSH, WI 54904
(920) 223-3550
1710972294 MOSSADIQ S JAFFRI MD
Individual
Psychiatry & Neurology (Neurology)2700 W 9TH AVE STE 203
OSHKOSH, WI 54904
(920) 223-2727
1740275122 DONALD J BRESCIA MD
Individual
Internal Medicine (Cardiovascular Disease)2700 W 9TH AVE STE 106
OSHKOSH, WI 54904
(920) 236-1750
1841285160 DAVID H ROMOND MD
Individual
Orthopaedic Surgery2700 W 9TH AVE
OSHKOSH, WI 54904
(920) 223-2600
1316934078 DEBORAH A ZELHOFER CNM
Individual
Advanced Practice Midwife2700 W 9TH AVE
OSHKOSH, WI 54904
(920) 223-0220
1497742159 JENNIFER E TAUBEL CNM
Individual
Advanced Practice Midwife2700 W 9TH AVE
OSHKOSH, WI 54904
(920) 223-0220
1194712851 JULIE S FEIL MSW LCSW
Individual
Social Worker (Clinical)2700 W 9TH AVE
OSHKOSH, WI 54904
(920) 223-2727
1619964541 JILLEEN L NEUMANN NP
Individual
Nurse Practitioner2700 W 9TH AVE
OSHKOSH, WI 54904
(920) 236-1984
1659369320 CHARLES D MORGAN MD
Individual
Psychiatry & Neurology (Psychiatry)2700 W 9TH AVE STE 320
OSHKOSH, WI 54904
(920) 223-3585
1497745855 ROBIN L MARX RN
Individual
2700 W 9TH AVE STE 220
OSHKOSH, WI 54904
(920) 223-3550
1578544946 HELEN A MOORE RN
Individual
2700 W 9TH AVE STE 220
OSHKOSH, WI 54904
(920) 223-2600
1255369351 DAVIS C. TSAI M.D.
Individual
Orthopaedic Surgery2700 W 9TH AVE SUITE 125
OSHKOSH, WI 54904
(920) 223-0123
1992735336 EMILIO CARLOS FERNANDEZ GATTI M.D.
Individual
Psychiatry & Neurology (Neurology)2700 W 9TH AVE SUITE 203
OSHKOSH, WI 54904
(920) 223-2727
1699789396 MARY F MCDONALD MD
Individual
Internal Medicine (Gastroenterology)2700 W 9TH AVE SUITE 300
OSHKOSH, WI 54904
(920) 223-0490
1750392239 LINDA L. KRONSCHNABEL PT
Individual
Physical Therapist2700 W 9TH AVE STE. 10
OSHKOSH, WI 54904
(920) 236-1862

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104862010, enumerated in the NPI registry as an "individual" on June 20, 2006

The provider is located at 2700 W 9th Ave Suite 125 Oshkosh, Wi 54904 and the phone number is (920) 223-0123

The provider's speciality is Orthopaedic Surgery with taxonomy code 207X00000X

The provider might be accepting Accepts: Molina Healthcare, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The provider has an overall high rating in the following quality measures: coordinates care and seeks improvement of health outcomes.

Medicare beneficiaries should expect a typical cost of $82.92 with an average copayment of $20.73 for new patient appointments. Established patients should expect a typical charge of $67.37 and an average copayment of 16.84. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Aspiration and/or injection of fluid from large joint, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Injection, triamcinolone acetonide, not otherwise specified, 10 mg, New patient office or other outpatient visit, 30-44 minutes, New patient office or other outpatient visit, 45-59 minutes, Replacement of knee joint, both sides of knee, Replacement of thigh bone and hip joint with prosthesis, X-ray of both hips, 2 views, X-ray of both knees while standing, X-ray of hip, 2-3 views, X-ray of knee, 3 views, X-ray of pelvis, 1-2 views and X-ray of spine, 1 view.

This NPI record was last updated on June 20, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.