| National Provider Identifier [NPI]: | 1497752448 |
| Last Name Of The Provider | SWALLOW |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 380 N 200 W |
| Street Address 2 Of The Provider | SUITE 209 |
| City Of The Provider | BOUNTIFUL |
| Zip Code Of The Provider | 840107079 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 148 |
| Number Of Services | 4174 |
| Number Of Medicare Beneficiaries | 2631 |
| Total Submitted Charge Amount | 530111.57 |
| Total Medicare Allowed Amount | 165224.93 |
| Total Medicare Payment Amount | 120053.04 |
| Total Medicare Standardized Payment Amount | 125844.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 344 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 2708.31 |
| Total Drug Medicare AllowedAmount | 170.55 |
| Total Drug Medicare PaymentAmount | 133.37 |
| Total Drug Medicare Standardized Payment Amount | 133.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 145 |
| Number Of Medical Services | 3830 |
| Number Of Medicare Beneficiaries With Medical Services | 2631 |
| Total Medical Submitted Charge Amount | 527403.26 |
| Total Medical Medicare Allowed Amount | 165054.38 |
| Total Medical Medicare Payment Amount | 119919.67 |
| Total Medical Medicare Standardized Payment Amount | 125711.17 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 362 |
| Number Of Beneficiaries Age 65 to 74 | 947 |
| Number Of Beneficiaries Age 75 to 84 | 835 |
| Number Of Beneficiaries Age Greater 84 | 487 |
| Number Of Female Beneficiaries | 1572 |
| Number Of Male Beneficiaries | 1059 |
| Number Of Non Hispanic White Beneficiaries | 2399 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | 48 |
| Number Of Hispanic Beneficiaries | 113 |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2263 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 368 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4318 |