| National Provider Identifier [NPI]: | 1447202700 |
| Last Name Of The Provider | TRAVIS |
| First Name Of The Provider | NATASHA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 840 N. 87TH STREET |
| Street Address 2 Of The Provider | SARGEANT HEALTH CENTER |
| City Of The Provider | MILWAUKEE |
| Zip Code Of The Provider | 53226 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 608 |
| Number Of Medicare Beneficiaries | 442 |
| Total Submitted Charge Amount | 99385 |
| Total Medicare Allowed Amount | 51105.31 |
| Total Medicare Payment Amount | 36319.94 |
| Total Medicare Standardized Payment Amount | 36261.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 608 |
| Number Of Medicare Beneficiaries With Medical Services | 442 |
| Total Medical Submitted Charge Amount | 99385 |
| Total Medical Medicare Allowed Amount | 51105.31 |
| Total Medical Medicare Payment Amount | 36319.94 |
| Total Medical Medicare Standardized Payment Amount | 36261.89 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 178 |
| Number Of Beneficiaries Age 65 to 74 | 173 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 258 |
| Number Of Male Beneficiaries | 184 |
| Number Of Non Hispanic White Beneficiaries | 23 |
| Number Of Black or African American Beneficiaries | 399 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 164 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 278 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.7476 |