| National Provider Identifier [NPI]: | 1831195262 |
| Last Name Of The Provider | BOGERT |
| First Name Of The Provider | GRACE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 210 VILLAGE CENTER PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | STOCKBRIDGE |
| Zip Code Of The Provider | 302819044 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 3758 |
| Number Of Medicare Beneficiaries | 827 |
| Total Submitted Charge Amount | 262629 |
| Total Medicare Allowed Amount | 159355.31 |
| Total Medicare Payment Amount | 108524.29 |
| Total Medicare Standardized Payment Amount | 132052.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 16 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 640 |
| Total Drug Medicare AllowedAmount | 523.37 |
| Total Drug Medicare PaymentAmount | 408.89 |
| Total Drug Medicare Standardized Payment Amount | 408.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 3742 |
| Number Of Medicare Beneficiaries With Medical Services | 827 |
| Total Medical Submitted Charge Amount | 261989 |
| Total Medical Medicare Allowed Amount | 158831.94 |
| Total Medical Medicare Payment Amount | 108115.4 |
| Total Medical Medicare Standardized Payment Amount | 131644.02 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 451 |
| Number Of Beneficiaries Age 75 to 84 | 231 |
| Number Of Beneficiaries Age Greater 84 | 81 |
| Number Of Female Beneficiaries | 538 |
| Number Of Male Beneficiaries | 289 |
| Number Of Non Hispanic White Beneficiaries | 786 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 785 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9549 |