| National Provider Identifier [NPI]: | 1982689428 |
| Last Name Of The Provider | BODI |
| First Name Of The Provider | KIP |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD FACS |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 775 PARK AVE |
| Street Address 2 Of The Provider | SUITE 262 |
| City Of The Provider | HUNTINGTON |
| Zip Code Of The Provider | 117433976 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 78 |
| Number Of Services | 6502 |
| Number Of Medicare Beneficiaries | 1022 |
| Total Submitted Charge Amount | 1267450.16 |
| Total Medicare Allowed Amount | 631440.33 |
| Total Medicare Payment Amount | 473425.63 |
| Total Medicare Standardized Payment Amount | 410008.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 1160 |
| Number Of Medicare Beneficiaries With Drug Services | 83 |
| Total Drug Submitted ChargeAmount | 110648.1 |
| Total Drug Medicare AllowedAmount | 43987.24 |
| Total Drug Medicare PaymentAmount | 33971 |
| Total Drug Medicare Standardized Payment Amount | 33971 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 5342 |
| Number Of Medicare Beneficiaries With Medical Services | 1022 |
| Total Medical Submitted Charge Amount | 1156802.06 |
| Total Medical Medicare Allowed Amount | 587453.09 |
| Total Medical Medicare Payment Amount | 439454.63 |
| Total Medical Medicare Standardized Payment Amount | 376037.67 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 125 |
| Number Of Beneficiaries Age 65 to 74 | 385 |
| Number Of Beneficiaries Age 75 to 84 | 315 |
| Number Of Beneficiaries Age Greater 84 | 197 |
| Number Of Female Beneficiaries | 219 |
| Number Of Male Beneficiaries | 803 |
| Number Of Non Hispanic White Beneficiaries | 882 |
| Number Of Black or African American Beneficiaries | 50 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 808 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 214 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4071 |