| National Provider Identifier [NPI]: | 1093710881 |
| Last Name Of The Provider | BANNEC |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 550 S LANDMARK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | BLOOMINGTON |
| Zip Code Of The Provider | 474033239 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 137 |
| Number Of Services | 12291 |
| Number Of Medicare Beneficiaries | 1253 |
| Total Submitted Charge Amount | 775718 |
| Total Medicare Allowed Amount | 405702.54 |
| Total Medicare Payment Amount | 308207.4 |
| Total Medicare Standardized Payment Amount | 322948.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 1306 |
| Number Of Medicare Beneficiaries With Drug Services | 230 |
| Total Drug Submitted ChargeAmount | 52035 |
| Total Drug Medicare AllowedAmount | 24458.68 |
| Total Drug Medicare PaymentAmount | 22028.59 |
| Total Drug Medicare Standardized Payment Amount | 22028.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 120 |
| Number Of Medical Services | 10985 |
| Number Of Medicare Beneficiaries With Medical Services | 1253 |
| Total Medical Submitted Charge Amount | 723683 |
| Total Medical Medicare Allowed Amount | 381243.86 |
| Total Medical Medicare Payment Amount | 286178.81 |
| Total Medical Medicare Standardized Payment Amount | 300919.47 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 113 |
| Number Of Beneficiaries Age 65 to 74 | 501 |
| Number Of Beneficiaries Age 75 to 84 | 371 |
| Number Of Beneficiaries Age Greater 84 | 268 |
| Number Of Female Beneficiaries | 721 |
| Number Of Male Beneficiaries | 532 |
| Number Of Non Hispanic White Beneficiaries | 1208 |
| Number Of Black or African American Beneficiaries | 12 |
| 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 | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1064 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 189 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3032 |