| National Provider Identifier [NPI]: | 1619060977 |
| Last Name Of The Provider | SWINK |
| First Name Of The Provider | TRAVIS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 105 S JOHN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DWIGHT |
| Zip Code Of The Provider | 604201413 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 2054 |
| Number Of Medicare Beneficiaries | 399 |
| Total Submitted Charge Amount | 285092 |
| Total Medicare Allowed Amount | 124046.4 |
| Total Medicare Payment Amount | 84758.15 |
| Total Medicare Standardized Payment Amount | 89202.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 178 |
| Number Of Medicare Beneficiaries With Drug Services | 95 |
| Total Drug Submitted ChargeAmount | 5286 |
| Total Drug Medicare AllowedAmount | 3543.28 |
| Total Drug Medicare PaymentAmount | 3453.23 |
| Total Drug Medicare Standardized Payment Amount | 3453.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 1876 |
| Number Of Medicare Beneficiaries With Medical Services | 399 |
| Total Medical Submitted Charge Amount | 279806 |
| Total Medical Medicare Allowed Amount | 120503.12 |
| Total Medical Medicare Payment Amount | 81304.92 |
| Total Medical Medicare Standardized Payment Amount | 85748.78 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 89 |
| Number Of Beneficiaries Age 65 to 74 | 145 |
| Number Of Beneficiaries Age 75 to 84 | 100 |
| Number Of Beneficiaries Age Greater 84 | 65 |
| Number Of Female Beneficiaries | 229 |
| Number Of Male Beneficiaries | 170 |
| 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 | 269 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 130 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3036 |