| National Provider Identifier [NPI]: | 1477591154 |
| Last Name Of The Provider | GIRGUIS |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 N PEPPER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | COLTON |
| Zip Code Of The Provider | 923241819 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 202 |
| Number Of Services | 8371 |
| Number Of Medicare Beneficiaries | 3250 |
| Total Submitted Charge Amount | 873305.69 |
| Total Medicare Allowed Amount | 302444.65 |
| Total Medicare Payment Amount | 235139.16 |
| Total Medicare Standardized Payment Amount | 236421.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 2839 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 5490 |
| Total Drug Medicare AllowedAmount | 1717.06 |
| Total Drug Medicare PaymentAmount | 1346.2 |
| Total Drug Medicare Standardized Payment Amount | 1346.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 196 |
| Number Of Medical Services | 5532 |
| Number Of Medicare Beneficiaries With Medical Services | 3249 |
| Total Medical Submitted Charge Amount | 867815.69 |
| Total Medical Medicare Allowed Amount | 300727.59 |
| Total Medical Medicare Payment Amount | 233792.96 |
| Total Medical Medicare Standardized Payment Amount | 235075.19 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 873 |
| Number Of Beneficiaries Age 65 to 74 | 1168 |
| Number Of Beneficiaries Age 75 to 84 | 840 |
| Number Of Beneficiaries Age Greater 84 | 369 |
| Number Of Female Beneficiaries | 1787 |
| Number Of Male Beneficiaries | 1463 |
| Number Of Non Hispanic White Beneficiaries | 1968 |
| Number Of Black or African American Beneficiaries | 334 |
| Number Of AsianPacific Islander Beneficiaries | 170 |
| Number Of Hispanic Beneficiaries | 690 |
| Number Of American Indian Alaska Native Beneficiaries | 19 |
| Number Of Beneficiaries With Race Not Else where Classified | 69 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1879 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1371 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.0437 |