| National Provider Identifier [NPI]: | 1992752554 |
| Last Name Of The Provider | BONIN |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 ORTHOPAEDIC PL |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST AUGUSTINE |
| Zip Code Of The Provider | 320864202 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 1733 |
| Number Of Medicare Beneficiaries | 640 |
| Total Submitted Charge Amount | 911048.06 |
| Total Medicare Allowed Amount | 115210.78 |
| Total Medicare Payment Amount | 86637.93 |
| Total Medicare Standardized Payment Amount | 96523.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 117 |
| Number Of Medicare Beneficiaries With Drug Services | 69 |
| Total Drug Submitted ChargeAmount | 567.68 |
| Total Drug Medicare AllowedAmount | 388.09 |
| Total Drug Medicare PaymentAmount | 283.44 |
| Total Drug Medicare Standardized Payment Amount | 283.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 1616 |
| Number Of Medicare Beneficiaries With Medical Services | 640 |
| Total Medical Submitted Charge Amount | 910480.38 |
| Total Medical Medicare Allowed Amount | 114822.69 |
| Total Medical Medicare Payment Amount | 86354.49 |
| Total Medical Medicare Standardized Payment Amount | 96239.62 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 70 |
| Number Of Beneficiaries Age 65 to 74 | 269 |
| Number Of Beneficiaries Age 75 to 84 | 222 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 411 |
| Number Of Male Beneficiaries | 229 |
| Number Of Non Hispanic White Beneficiaries | 584 |
| Number Of Black or African American Beneficiaries | 31 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 548 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 72 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2318 |