| National Provider Identifier [NPI]: | 1861438004 |
| Last Name Of The Provider | BOGAARD |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1245 WILSHIRE BLVD |
| Street Address 2 Of The Provider | SUITE 306 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900174803 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 1263 |
| Number Of Medicare Beneficiaries | 310 |
| Total Submitted Charge Amount | 317800 |
| Total Medicare Allowed Amount | 137432.24 |
| Total Medicare Payment Amount | 101547.03 |
| Total Medicare Standardized Payment Amount | 94999.96 |
| Drug Suppress Indicator | * |
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| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 131 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 49 |
| Number Of Female Beneficiaries | 64 |
| Number Of Male Beneficiaries | 246 |
| Number Of Non Hispanic White Beneficiaries | 74 |
| Number Of Black or African American Beneficiaries | 61 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 155 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 121 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 189 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.1696 |