| National Provider Identifier [NPI]: | 1154508075 |
| Last Name Of The Provider | BANKS |
| First Name Of The Provider | JOE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 922 E UNIVERSITY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRANGER |
| Zip Code Of The Provider | 465304466 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Osteopathic Manipulative Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 943 |
| Number Of Medicare Beneficiaries | 216 |
| Total Submitted Charge Amount | 74334 |
| Total Medicare Allowed Amount | 52914.7 |
| Total Medicare Payment Amount | 35425.91 |
| Total Medicare Standardized Payment Amount | 38274.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 71 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 1700 |
| Total Drug Medicare AllowedAmount | 1333.75 |
| Total Drug Medicare PaymentAmount | 1295.54 |
| Total Drug Medicare Standardized Payment Amount | 1295.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 872 |
| Number Of Medicare Beneficiaries With Medical Services | 216 |
| Total Medical Submitted Charge Amount | 72634 |
| Total Medical Medicare Allowed Amount | 51580.95 |
| Total Medical Medicare Payment Amount | 34130.37 |
| Total Medical Medicare Standardized Payment Amount | 36979.15 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 115 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 119 |
| Number Of Male Beneficiaries | 97 |
| Number Of Non Hispanic White Beneficiaries | 167 |
| Number Of Black or African American Beneficiaries | 37 |
| 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 | 195 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9568 |