| National Provider Identifier [NPI]: | 1760410542 |
| Last Name Of The Provider | BANWART |
| First Name Of The Provider | JON |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 444 FOUR STATES DR SUITE 1 |
| Street Address 2 Of The Provider | |
| City Of The Provider | GALENA |
| Zip Code Of The Provider | 667394325 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 7034 |
| Number Of Medicare Beneficiaries | 1047 |
| Total Submitted Charge Amount | 2727404 |
| Total Medicare Allowed Amount | 629034.12 |
| Total Medicare Payment Amount | 479814.62 |
| Total Medicare Standardized Payment Amount | 516000.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2521 |
| Number Of Medicare Beneficiaries With Drug Services | 302 |
| Total Drug Submitted ChargeAmount | 70407 |
| Total Drug Medicare AllowedAmount | 26919.55 |
| Total Drug Medicare PaymentAmount | 20120.8 |
| Total Drug Medicare Standardized Payment Amount | 20120.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 4513 |
| Number Of Medicare Beneficiaries With Medical Services | 1047 |
| Total Medical Submitted Charge Amount | 2656997 |
| Total Medical Medicare Allowed Amount | 602114.57 |
| Total Medical Medicare Payment Amount | 459693.82 |
| Total Medical Medicare Standardized Payment Amount | 495879.59 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 132 |
| Number Of Beneficiaries Age 65 to 74 | 502 |
| Number Of Beneficiaries Age 75 to 84 | 331 |
| Number Of Beneficiaries Age Greater 84 | 82 |
| Number Of Female Beneficiaries | 629 |
| Number Of Male Beneficiaries | 418 |
| Number Of Non Hispanic White Beneficiaries | 997 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 28 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 926 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 121 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0343 |