| National Provider Identifier [NPI]: | 1871556829 |
| Last Name Of The Provider | BODEMANN |
| First Name Of The Provider | DIANE |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1662 HIGDON FERRY RD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | HOT SPRINGS |
| Zip Code Of The Provider | 719136912 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 137 |
| Number Of Services | 11819 |
| Number Of Medicare Beneficiaries | 787 |
| Total Submitted Charge Amount | 756676 |
| Total Medicare Allowed Amount | 349971.14 |
| Total Medicare Payment Amount | 279715.96 |
| Total Medicare Standardized Payment Amount | 300855.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 19 |
| Number Of Drug Services | 1011 |
| Number Of Medicare Beneficiaries With Drug Services | 285 |
| Total Drug Submitted ChargeAmount | 20837 |
| Total Drug Medicare AllowedAmount | 14153.87 |
| Total Drug Medicare PaymentAmount | 12701.55 |
| Total Drug Medicare Standardized Payment Amount | 12701.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 118 |
| Number Of Medical Services | 10808 |
| Number Of Medicare Beneficiaries With Medical Services | 787 |
| Total Medical Submitted Charge Amount | 735839 |
| Total Medical Medicare Allowed Amount | 335817.27 |
| Total Medical Medicare Payment Amount | 267014.41 |
| Total Medical Medicare Standardized Payment Amount | 288153.54 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 260 |
| Number Of Beneficiaries Age 75 to 84 | 323 |
| Number Of Beneficiaries Age Greater 84 | 158 |
| Number Of Female Beneficiaries | 646 |
| Number Of Male Beneficiaries | 141 |
| Number Of Non Hispanic White Beneficiaries | 758 |
| 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 | 722 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 65 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1388 |