| National Provider Identifier [NPI]: | 1588681191 |
| Last Name Of The Provider | BODOR |
| First Name Of The Provider | MARKO |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3421 VILLA LN |
| Street Address 2 Of The Provider | SUITE 2B |
| City Of The Provider | NAPA |
| Zip Code Of The Provider | 945586402 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 9740 |
| Number Of Medicare Beneficiaries | 476 |
| Total Submitted Charge Amount | 702393.24 |
| Total Medicare Allowed Amount | 417887.97 |
| Total Medicare Payment Amount | 318580.16 |
| Total Medicare Standardized Payment Amount | 269174.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 6495 |
| Number Of Medicare Beneficiaries With Drug Services | 306 |
| Total Drug Submitted ChargeAmount | 87512.6 |
| Total Drug Medicare AllowedAmount | 37062.85 |
| Total Drug Medicare PaymentAmount | 29023.59 |
| Total Drug Medicare Standardized Payment Amount | 29023.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 92 |
| Number Of Medical Services | 3245 |
| Number Of Medicare Beneficiaries With Medical Services | 476 |
| Total Medical Submitted Charge Amount | 614880.64 |
| Total Medical Medicare Allowed Amount | 380825.12 |
| Total Medical Medicare Payment Amount | 289556.57 |
| Total Medical Medicare Standardized Payment Amount | 240151.2 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 224 |
| Number Of Beneficiaries Age 75 to 84 | 148 |
| Number Of Beneficiaries Age Greater 84 | 62 |
| Number Of Female Beneficiaries | 268 |
| Number Of Male Beneficiaries | 208 |
| Number Of Non Hispanic White Beneficiaries | 439 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 435 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0051 |