| National Provider Identifier [NPI]: | 1407809130 |
| Last Name Of The Provider | SAWASKY |
| First Name Of The Provider | KATHLEEN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 21700 INTERTECH DR |
| Street Address 2 Of The Provider | SPRINGDALE HEALTH CENTER |
| City Of The Provider | BROOKFIELD |
| Zip Code Of The Provider | 530455197 |
| 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 | 38 |
| Number Of Services | 842 |
| Number Of Medicare Beneficiaries | 220 |
| Total Submitted Charge Amount | 165981.08 |
| Total Medicare Allowed Amount | 54056.06 |
| Total Medicare Payment Amount | 38588.75 |
| Total Medicare Standardized Payment Amount | 41442.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 163 |
| Number Of Medicare Beneficiaries With Drug Services | 105 |
| Total Drug Submitted ChargeAmount | 4745.33 |
| Total Drug Medicare AllowedAmount | 3297.33 |
| Total Drug Medicare PaymentAmount | 3133.73 |
| Total Drug Medicare Standardized Payment Amount | 3133.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 679 |
| Number Of Medicare Beneficiaries With Medical Services | 220 |
| Total Medical Submitted Charge Amount | 161235.75 |
| Total Medical Medicare Allowed Amount | 50758.73 |
| Total Medical Medicare Payment Amount | 35455.02 |
| Total Medical Medicare Standardized Payment Amount | 38309.13 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 116 |
| Number Of Beneficiaries Age 75 to 84 | 66 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 195 |
| Number Of Male Beneficiaries | 25 |
| 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 | 204 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9042 |