| National Provider Identifier [NPI]: | 1538183116 |
| Last Name Of The Provider | BANMAN |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3555 LOMA VISTA RD |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | VENTURA |
| Zip Code Of The Provider | 930033161 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 4511 |
| Number Of Medicare Beneficiaries | 1509 |
| Total Submitted Charge Amount | 353452.94 |
| Total Medicare Allowed Amount | 349613.7 |
| Total Medicare Payment Amount | 258914.78 |
| Total Medicare Standardized Payment Amount | 241809.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 745 |
| Number Of Medicare Beneficiaries With Drug Services | 486 |
| Total Drug Submitted ChargeAmount | 10390.51 |
| Total Drug Medicare AllowedAmount | 8685.01 |
| Total Drug Medicare PaymentAmount | 8320.14 |
| Total Drug Medicare Standardized Payment Amount | 8320.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 3766 |
| Number Of Medicare Beneficiaries With Medical Services | 1492 |
| Total Medical Submitted Charge Amount | 343062.43 |
| Total Medical Medicare Allowed Amount | 340928.69 |
| Total Medical Medicare Payment Amount | 250594.64 |
| Total Medical Medicare Standardized Payment Amount | 233489.28 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 85 |
| Number Of Beneficiaries Age 65 to 74 | 727 |
| Number Of Beneficiaries Age 75 to 84 | 444 |
| Number Of Beneficiaries Age Greater 84 | 253 |
| Number Of Female Beneficiaries | 971 |
| Number Of Male Beneficiaries | 538 |
| Number Of Non Hispanic White Beneficiaries | 1286 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 33 |
| Number Of Hispanic Beneficiaries | 143 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1473 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0276 |