| National Provider Identifier [NPI]: | 1619973534 |
| Last Name Of The Provider | BONAVENTE |
| First Name Of The Provider | ARNULFO |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6409 CRAIN HWY |
| Street Address 2 Of The Provider | ROUTE 301 |
| City Of The Provider | UPPER MARLBORO |
| Zip Code Of The Provider | 207724139 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 1146 |
| Number Of Medicare Beneficiaries | 279 |
| Total Submitted Charge Amount | 179897 |
| Total Medicare Allowed Amount | 101919.91 |
| Total Medicare Payment Amount | 70102.98 |
| Total Medicare Standardized Payment Amount | 66465.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 141 |
| Number Of Medicare Beneficiaries With Drug Services | 115 |
| Total Drug Submitted ChargeAmount | 6896 |
| Total Drug Medicare AllowedAmount | 4245.03 |
| Total Drug Medicare PaymentAmount | 3797.13 |
| Total Drug Medicare Standardized Payment Amount | 3797.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 1005 |
| Number Of Medicare Beneficiaries With Medical Services | 279 |
| Total Medical Submitted Charge Amount | 173001 |
| Total Medical Medicare Allowed Amount | 97674.88 |
| Total Medical Medicare Payment Amount | 66305.85 |
| Total Medical Medicare Standardized Payment Amount | 62668.4 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 153 |
| Number Of Beneficiaries Age 75 to 84 | 64 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 151 |
| Number Of Male Beneficiaries | 128 |
| Number Of Non Hispanic White Beneficiaries | 97 |
| Number Of Black or African American Beneficiaries | 163 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 244 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0095 |