| National Provider Identifier [NPI]: | 1073529665 |
| Last Name Of The Provider | TOURSARKISSIAN |
| First Name Of The Provider | BOULOS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4330 MEDICAL DR |
| Street Address 2 Of The Provider | SUITE 120 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782293342 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 151 |
| Number Of Services | 6438 |
| Number Of Medicare Beneficiaries | 953 |
| Total Submitted Charge Amount | 2847348.8 |
| Total Medicare Allowed Amount | 948371.53 |
| Total Medicare Payment Amount | 736138.96 |
| Total Medicare Standardized Payment Amount | 789302.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 3906 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 4500 |
| Total Drug Medicare AllowedAmount | 1100.03 |
| Total Drug Medicare PaymentAmount | 862.4 |
| Total Drug Medicare Standardized Payment Amount | 862.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 149 |
| Number Of Medical Services | 2532 |
| Number Of Medicare Beneficiaries With Medical Services | 953 |
| Total Medical Submitted Charge Amount | 2842848.8 |
| Total Medical Medicare Allowed Amount | 947271.5 |
| Total Medical Medicare Payment Amount | 735276.56 |
| Total Medical Medicare Standardized Payment Amount | 788440.28 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 332 |
| Number Of Beneficiaries Age 65 to 74 | 332 |
| Number Of Beneficiaries Age 75 to 84 | 208 |
| Number Of Beneficiaries Age Greater 84 | 81 |
| Number Of Female Beneficiaries | 440 |
| Number Of Male Beneficiaries | 513 |
| Number Of Non Hispanic White Beneficiaries | 325 |
| Number Of Black or African American Beneficiaries | 59 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 554 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 560 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 393 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 71 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 73 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 4.7755 |