| National Provider Identifier [NPI]: | 1598750747 |
| Last Name Of The Provider | BANAS |
| First Name Of The Provider | JON |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3680 BROADWAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339018005 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 254 |
| Number Of Services | 63440 |
| Number Of Medicare Beneficiaries | 7438 |
| Total Submitted Charge Amount | 3023992.4 |
| Total Medicare Allowed Amount | 810263.76 |
| Total Medicare Payment Amount | 612404.57 |
| Total Medicare Standardized Payment Amount | 590324.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 52920 |
| Number Of Medicare Beneficiaries With Drug Services | 614 |
| Total Drug Submitted ChargeAmount | 68646.04 |
| Total Drug Medicare AllowedAmount | 11047.06 |
| Total Drug Medicare PaymentAmount | 8594.6 |
| Total Drug Medicare Standardized Payment Amount | 8594.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 251 |
| Number Of Medical Services | 10520 |
| Number Of Medicare Beneficiaries With Medical Services | 7432 |
| Total Medical Submitted Charge Amount | 2955346.36 |
| Total Medical Medicare Allowed Amount | 799216.7 |
| Total Medical Medicare Payment Amount | 603809.97 |
| Total Medical Medicare Standardized Payment Amount | 581729.86 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 762 |
| Number Of Beneficiaries Age 65 to 74 | 3234 |
| Number Of Beneficiaries Age 75 to 84 | 2473 |
| Number Of Beneficiaries Age Greater 84 | 969 |
| Number Of Female Beneficiaries | 4274 |
| Number Of Male Beneficiaries | 3164 |
| Number Of Non Hispanic White Beneficiaries | 6561 |
| Number Of Black or African American Beneficiaries | 217 |
| Number Of AsianPacific Islander Beneficiaries | 37 |
| Number Of Hispanic Beneficiaries | 515 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | 97 |
| Number Of Beneficiaries With Medicare Only Entitlement | 6389 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1049 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4605 |