| National Provider Identifier [NPI]: | 1023089646 |
| Last Name Of The Provider | BONATUS |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1485 N TURQUOISE DR |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | FLAGSTAFF |
| Zip Code Of The Provider | 860011398 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 82 |
| Number Of Services | 3729 |
| Number Of Medicare Beneficiaries | 401 |
| Total Submitted Charge Amount | 929529.05 |
| Total Medicare Allowed Amount | 251655.02 |
| Total Medicare Payment Amount | 190795.86 |
| Total Medicare Standardized Payment Amount | 192887.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 2307 |
| Number Of Medicare Beneficiaries With Drug Services | 115 |
| Total Drug Submitted ChargeAmount | 99202 |
| Total Drug Medicare AllowedAmount | 27348.13 |
| Total Drug Medicare PaymentAmount | 21413.34 |
| Total Drug Medicare Standardized Payment Amount | 21413.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 1422 |
| Number Of Medicare Beneficiaries With Medical Services | 401 |
| Total Medical Submitted Charge Amount | 830327.05 |
| Total Medical Medicare Allowed Amount | 224306.89 |
| Total Medical Medicare Payment Amount | 169382.52 |
| Total Medical Medicare Standardized Payment Amount | 171474.65 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 186 |
| Number Of Beneficiaries Age 75 to 84 | 116 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 245 |
| Number Of Male Beneficiaries | 156 |
| Number Of Non Hispanic White Beneficiaries | 249 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 125 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 286 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 115 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.982 |