| National Provider Identifier [NPI]: | 1265412498 |
| Last Name Of The Provider | GHISELLI |
| First Name Of The Provider | ANTONIO |
| 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 | 1720 MURCHISON |
| Street Address 2 Of The Provider | |
| City Of The Provider | EL PASO |
| Zip Code Of The Provider | 79902 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 3264 |
| Number Of Medicare Beneficiaries | 307 |
| Total Submitted Charge Amount | 300399 |
| Total Medicare Allowed Amount | 132532.77 |
| Total Medicare Payment Amount | 96046.02 |
| Total Medicare Standardized Payment Amount | 100772.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1316 |
| Number Of Medicare Beneficiaries With Drug Services | 96 |
| Total Drug Submitted ChargeAmount | 40515 |
| Total Drug Medicare AllowedAmount | 14857 |
| Total Drug Medicare PaymentAmount | 11641.77 |
| Total Drug Medicare Standardized Payment Amount | 11641.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 1948 |
| Number Of Medicare Beneficiaries With Medical Services | 307 |
| Total Medical Submitted Charge Amount | 259884 |
| Total Medical Medicare Allowed Amount | 117675.77 |
| Total Medical Medicare Payment Amount | 84404.25 |
| Total Medical Medicare Standardized Payment Amount | 89130.82 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 111 |
| Number Of Beneficiaries Age 75 to 84 | 110 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 203 |
| Number Of Male Beneficiaries | 104 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 202 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 214 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 93 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2802 |