| National Provider Identifier [NPI]: | 1255479044 |
| Last Name Of The Provider | BOGHOSIAN |
| First Name Of The Provider | GHASSAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 47110 WASHINGTON ST |
| Street Address 2 Of The Provider | SUITE 103 |
| City Of The Provider | LA QUINTA |
| Zip Code Of The Provider | 922532186 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 1764 |
| Number Of Medicare Beneficiaries | 433 |
| Total Submitted Charge Amount | 1678202 |
| Total Medicare Allowed Amount | 364603.08 |
| Total Medicare Payment Amount | 278635.56 |
| Total Medicare Standardized Payment Amount | 280406.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 307 |
| Number Of Medicare Beneficiaries With Drug Services | 121 |
| Total Drug Submitted ChargeAmount | 53930 |
| Total Drug Medicare AllowedAmount | 26812.32 |
| Total Drug Medicare PaymentAmount | 20853.02 |
| Total Drug Medicare Standardized Payment Amount | 20853.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 1457 |
| Number Of Medicare Beneficiaries With Medical Services | 433 |
| Total Medical Submitted Charge Amount | 1624272 |
| Total Medical Medicare Allowed Amount | 337790.76 |
| Total Medical Medicare Payment Amount | 257782.54 |
| Total Medical Medicare Standardized Payment Amount | 259553.12 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 196 |
| Number Of Beneficiaries Age 75 to 84 | 167 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 280 |
| Number Of Male Beneficiaries | 153 |
| Number Of Non Hispanic White Beneficiaries | 364 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 56 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 386 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.159 |