| National Provider Identifier [NPI]: | 1114919149 |
| Last Name Of The Provider | TRAVNICEK |
| First Name Of The Provider | PETRA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1250 SOUTH TAMIAMI TRAIL |
| Street Address 2 Of The Provider | SUITE 301 |
| City Of The Provider | SARASOTA |
| Zip Code Of The Provider | 342392207 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 1718 |
| Number Of Medicare Beneficiaries | 386 |
| Total Submitted Charge Amount | 238550 |
| Total Medicare Allowed Amount | 119654.97 |
| Total Medicare Payment Amount | 87486.17 |
| Total Medicare Standardized Payment Amount | 88567.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 95 |
| Number Of Medicare Beneficiaries With Drug Services | 83 |
| Total Drug Submitted ChargeAmount | 3699 |
| Total Drug Medicare AllowedAmount | 1919.88 |
| Total Drug Medicare PaymentAmount | 1853.44 |
| Total Drug Medicare Standardized Payment Amount | 1853.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 1623 |
| Number Of Medicare Beneficiaries With Medical Services | 386 |
| Total Medical Submitted Charge Amount | 234851 |
| Total Medical Medicare Allowed Amount | 117735.09 |
| Total Medical Medicare Payment Amount | 85632.73 |
| Total Medical Medicare Standardized Payment Amount | 86713.71 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 129 |
| Number Of Beneficiaries Age 75 to 84 | 134 |
| Number Of Beneficiaries Age Greater 84 | 105 |
| Number Of Female Beneficiaries | 245 |
| Number Of Male Beneficiaries | 141 |
| Number Of Non Hispanic White Beneficiaries | 367 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 374 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0652 |