| National Provider Identifier [NPI]: | 1245560770 |
| Last Name Of The Provider | LENDER |
| First Name Of The Provider | BONNIE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 211 NEW BRITAIN ROAD |
| Street Address 2 Of The Provider | SUITE 105 |
| City Of The Provider | KENSINGTON |
| Zip Code Of The Provider | 06037 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 693 |
| Number Of Medicare Beneficiaries | 76 |
| Total Submitted Charge Amount | 52688.01 |
| Total Medicare Allowed Amount | 27466.74 |
| Total Medicare Payment Amount | 21992.96 |
| Total Medicare Standardized Payment Amount | 23492.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 40 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 1304.01 |
| Total Drug Medicare AllowedAmount | 1011.09 |
| Total Drug Medicare PaymentAmount | 988.04 |
| Total Drug Medicare Standardized Payment Amount | 988.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 653 |
| Number Of Medicare Beneficiaries With Medical Services | 76 |
| Total Medical Submitted Charge Amount | 51384 |
| Total Medical Medicare Allowed Amount | 26455.65 |
| Total Medical Medicare Payment Amount | 21004.92 |
| Total Medical Medicare Standardized Payment Amount | 22504.45 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 34 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 52 |
| Number Of Male Beneficiaries | 24 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 49 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 28 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 24 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.5182 |