| National Provider Identifier [NPI]: | 1134280605 |
| Last Name Of The Provider | BODKIN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5555 GROSSMONT CENTER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | LA MESA |
| Zip Code Of The Provider | 919423019 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 97 |
| Number Of Services | 180320 |
| Number Of Medicare Beneficiaries | 582 |
| Total Submitted Charge Amount | 4642273.18 |
| Total Medicare Allowed Amount | 2341711.71 |
| Total Medicare Payment Amount | 1796173.35 |
| Total Medicare Standardized Payment Amount | 1784571.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 64 |
| Number Of Drug Services | 176051 |
| Number Of Medicare Beneficiaries With Drug Services | 179 |
| Total Drug Submitted ChargeAmount | 4097881.18 |
| Total Drug Medicare AllowedAmount | 2048614.57 |
| Total Drug Medicare PaymentAmount | 1578277.79 |
| Total Drug Medicare Standardized Payment Amount | 1578277.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 4269 |
| Number Of Medicare Beneficiaries With Medical Services | 579 |
| Total Medical Submitted Charge Amount | 544392 |
| Total Medical Medicare Allowed Amount | 293097.14 |
| Total Medical Medicare Payment Amount | 217895.56 |
| Total Medical Medicare Standardized Payment Amount | 206293.59 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 80 |
| Number Of Beneficiaries Age 65 to 74 | 216 |
| Number Of Beneficiaries Age 75 to 84 | 188 |
| Number Of Beneficiaries Age Greater 84 | 98 |
| Number Of Female Beneficiaries | 390 |
| Number Of Male Beneficiaries | 192 |
| Number Of Non Hispanic White Beneficiaries | 482 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 418 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 164 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 51 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.7857 |