| National Provider Identifier [NPI]: | 1366446312 |
| Last Name Of The Provider | BONAVITA |
| First Name Of The Provider | FRANK |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2240 N HARBOR BLVD |
| Street Address 2 Of The Provider | STE 200 |
| City Of The Provider | FULLERTON |
| Zip Code Of The Provider | 928352635 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 2505 |
| Number Of Medicare Beneficiaries | 721 |
| Total Submitted Charge Amount | 706560 |
| Total Medicare Allowed Amount | 332950.4 |
| Total Medicare Payment Amount | 247619.98 |
| Total Medicare Standardized Payment Amount | 215652.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 121 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 7910 |
| Total Drug Medicare AllowedAmount | 3890.64 |
| Total Drug Medicare PaymentAmount | 3051.83 |
| Total Drug Medicare Standardized Payment Amount | 3051.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 2384 |
| Number Of Medicare Beneficiaries With Medical Services | 721 |
| Total Medical Submitted Charge Amount | 698650 |
| Total Medical Medicare Allowed Amount | 329059.76 |
| Total Medical Medicare Payment Amount | 244568.15 |
| Total Medical Medicare Standardized Payment Amount | 212600.56 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 254 |
| Number Of Beneficiaries Age 75 to 84 | 272 |
| Number Of Beneficiaries Age Greater 84 | 162 |
| Number Of Female Beneficiaries | 373 |
| Number Of Male Beneficiaries | 348 |
| Number Of Non Hispanic White Beneficiaries | 600 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | 40 |
| Number Of Hispanic Beneficiaries | 50 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 658 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4467 |