| National Provider Identifier [NPI]: | 1639191646 |
| Last Name Of The Provider | BANKS |
| First Name Of The Provider | ALAN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2193 NORTHLAKE PKWY |
| Street Address 2 Of The Provider | STE 114 |
| City Of The Provider | TUCKER |
| Zip Code Of The Provider | 300844116 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 1948 |
| Number Of Medicare Beneficiaries | 521 |
| Total Submitted Charge Amount | 383504 |
| Total Medicare Allowed Amount | 121605.59 |
| Total Medicare Payment Amount | 84741.34 |
| Total Medicare Standardized Payment Amount | 86657.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 287 |
| Number Of Medicare Beneficiaries With Drug Services | 43 |
| Total Drug Submitted ChargeAmount | 1624 |
| Total Drug Medicare AllowedAmount | 115.82 |
| Total Drug Medicare PaymentAmount | 87.66 |
| Total Drug Medicare Standardized Payment Amount | 87.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 1661 |
| Number Of Medicare Beneficiaries With Medical Services | 521 |
| Total Medical Submitted Charge Amount | 381880 |
| Total Medical Medicare Allowed Amount | 121489.77 |
| Total Medical Medicare Payment Amount | 84653.68 |
| Total Medical Medicare Standardized Payment Amount | 86569.88 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 201 |
| Number Of Beneficiaries Age 75 to 84 | 185 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 327 |
| Number Of Male Beneficiaries | 194 |
| Number Of Non Hispanic White Beneficiaries | 414 |
| Number Of Black or African American Beneficiaries | 82 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 477 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2701 |