| National Provider Identifier [NPI]: | 1821022252 |
| Last Name Of The Provider | KOBAN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.C. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 636 W REPUBLIC RD |
| Street Address 2 Of The Provider | SUITE 108 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 658075818 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Chiropractic |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 2 |
| Number Of Services | 4468 |
| Number Of Medicare Beneficiaries | 351 |
| Total Submitted Charge Amount | 164270.37 |
| Total Medicare Allowed Amount | 129576.69 |
| Total Medicare Payment Amount | 99831.49 |
| Total Medicare Standardized Payment Amount | 106993.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 2 |
| Number Of Medical Services | 4468 |
| Number Of Medicare Beneficiaries With Medical Services | 351 |
| Total Medical Submitted Charge Amount | 164270.37 |
| Total Medical Medicare Allowed Amount | 129576.69 |
| Total Medical Medicare Payment Amount | 99831.49 |
| Total Medical Medicare Standardized Payment Amount | 106993.78 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 83 |
| Number Of Beneficiaries Age 65 to 74 | 140 |
| Number Of Beneficiaries Age 75 to 84 | 98 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 193 |
| Number Of Male Beneficiaries | 158 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 279 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 72 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1168 |