| National Provider Identifier [NPI]: | 1184671620 |
| Last Name Of The Provider | FROMWILLER |
| First Name Of The Provider | TRAVIS |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2925 RYAN DR SE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SALEM |
| Zip Code Of The Provider | 973019687 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 165 |
| Number Of Services | 2983 |
| Number Of Medicare Beneficiaries | 1703 |
| Total Submitted Charge Amount | 401065.2 |
| Total Medicare Allowed Amount | 136293.02 |
| Total Medicare Payment Amount | 108059.43 |
| Total Medicare Standardized Payment Amount | 112845.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 403 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 2679.7 |
| Total Drug Medicare AllowedAmount | 799.75 |
| Total Drug Medicare PaymentAmount | 627.01 |
| Total Drug Medicare Standardized Payment Amount | 627.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 163 |
| Number Of Medical Services | 2580 |
| Number Of Medicare Beneficiaries With Medical Services | 1703 |
| Total Medical Submitted Charge Amount | 398385.5 |
| Total Medical Medicare Allowed Amount | 135493.27 |
| Total Medical Medicare Payment Amount | 107432.42 |
| Total Medical Medicare Standardized Payment Amount | 112218.8 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 352 |
| Number Of Beneficiaries Age 65 to 74 | 697 |
| Number Of Beneficiaries Age 75 to 84 | 419 |
| Number Of Beneficiaries Age Greater 84 | 235 |
| Number Of Female Beneficiaries | 1115 |
| Number Of Male Beneficiaries | 588 |
| Number Of Non Hispanic White Beneficiaries | 1494 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 125 |
| Number Of American Indian Alaska Native Beneficiaries | 30 |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1236 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 467 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4125 |