| National Provider Identifier [NPI]: | 1811951072 |
| Last Name Of The Provider | BANNO |
| First Name Of The Provider | JOSEPH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7309 N KNOXVILLE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PEORIA |
| Zip Code Of The Provider | 616142085 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 150 |
| Number Of Services | 14080 |
| Number Of Medicare Beneficiaries | 944 |
| Total Submitted Charge Amount | 5638413.3 |
| Total Medicare Allowed Amount | 742086.47 |
| Total Medicare Payment Amount | 543229.74 |
| Total Medicare Standardized Payment Amount | 615618.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 3748 |
| Number Of Medicare Beneficiaries With Drug Services | 138 |
| Total Drug Submitted ChargeAmount | 137063.3 |
| Total Drug Medicare AllowedAmount | 34322.07 |
| Total Drug Medicare PaymentAmount | 25662.09 |
| Total Drug Medicare Standardized Payment Amount | 25662.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 135 |
| Number Of Medical Services | 10332 |
| Number Of Medicare Beneficiaries With Medical Services | 944 |
| Total Medical Submitted Charge Amount | 5501350 |
| Total Medical Medicare Allowed Amount | 707764.4 |
| Total Medical Medicare Payment Amount | 517567.65 |
| Total Medical Medicare Standardized Payment Amount | 589956 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 507 |
| Number Of Beneficiaries Age 75 to 84 | 281 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 122 |
| Number Of Male Beneficiaries | 822 |
| Number Of Non Hispanic White Beneficiaries | 862 |
| Number Of Black or African American Beneficiaries | 59 |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 858 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 27 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 2 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0698 |