| National Provider Identifier [NPI]: | 1538115894 |
| Last Name Of The Provider | SCOTT |
| First Name Of The Provider | TRAVIS |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 54 HOSPITAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | OSAGE BEACH |
| Zip Code Of The Provider | 650653050 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 180 |
| Number Of Services | 7713 |
| Number Of Medicare Beneficiaries | 2693 |
| Total Submitted Charge Amount | 750536 |
| Total Medicare Allowed Amount | 192965.65 |
| Total Medicare Payment Amount | 146574.38 |
| Total Medicare Standardized Payment Amount | 153410.63 |
| 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 | 180 |
| Number Of Medical Services | 7713 |
| Number Of Medicare Beneficiaries With Medical Services | 2693 |
| Total Medical Submitted Charge Amount | 750536 |
| Total Medical Medicare Allowed Amount | 192965.65 |
| Total Medical Medicare Payment Amount | 146574.38 |
| Total Medical Medicare Standardized Payment Amount | 153410.63 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 428 |
| Number Of Beneficiaries Age 65 to 74 | 785 |
| Number Of Beneficiaries Age 75 to 84 | 864 |
| Number Of Beneficiaries Age Greater 84 | 616 |
| Number Of Female Beneficiaries | 1492 |
| Number Of Male Beneficiaries | 1201 |
| Number Of Non Hispanic White Beneficiaries | 2531 |
| Number Of Black or African American Beneficiaries | 43 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 84 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1985 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 708 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4607 |