| National Provider Identifier [NPI]: | 1720139090 |
| Last Name Of The Provider | BODNER |
| First Name Of The Provider | GAIL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 734 N FRANKLIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LANCASTER |
| Zip Code Of The Provider | 176022176 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 296 |
| Number Of Medicare Beneficiaries | 57 |
| Total Submitted Charge Amount | 20951 |
| Total Medicare Allowed Amount | 15280.51 |
| Total Medicare Payment Amount | 11738.02 |
| Total Medicare Standardized Payment Amount | 12451.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 1414 |
| Total Drug Medicare AllowedAmount | 1000.54 |
| Total Drug Medicare PaymentAmount | 965.16 |
| Total Drug Medicare Standardized Payment Amount | 965.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 262 |
| Number Of Medicare Beneficiaries With Medical Services | 57 |
| Total Medical Submitted Charge Amount | 19537 |
| Total Medical Medicare Allowed Amount | 14279.97 |
| Total Medical Medicare Payment Amount | 10772.86 |
| Total Medical Medicare Standardized Payment Amount | 11486.25 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 39 |
| Number Of Male Beneficiaries | 18 |
| Number Of Non Hispanic White Beneficiaries | 32 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 17 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0864 |