| National Provider Identifier [NPI]: | 1144343435 |
| Last Name Of The Provider | HOGAN |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20 OAK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | EUFAULA |
| Zip Code Of The Provider | 74432 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 4925 |
| Number Of Medicare Beneficiaries | 671 |
| Total Submitted Charge Amount | 295484.55 |
| Total Medicare Allowed Amount | 136561.59 |
| Total Medicare Payment Amount | 100643.54 |
| Total Medicare Standardized Payment Amount | 107072.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 22 |
| Number Of Drug Services | 2546 |
| Number Of Medicare Beneficiaries With Drug Services | 284 |
| Total Drug Submitted ChargeAmount | 36893 |
| Total Drug Medicare AllowedAmount | 2693.36 |
| Total Drug Medicare PaymentAmount | 2071.6 |
| Total Drug Medicare Standardized Payment Amount | 2071.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 95 |
| Number Of Medical Services | 2379 |
| Number Of Medicare Beneficiaries With Medical Services | 671 |
| Total Medical Submitted Charge Amount | 258591.55 |
| Total Medical Medicare Allowed Amount | 133868.23 |
| Total Medical Medicare Payment Amount | 98571.94 |
| Total Medical Medicare Standardized Payment Amount | 105001.25 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 184 |
| Number Of Beneficiaries Age 65 to 74 | 276 |
| Number Of Beneficiaries Age 75 to 84 | 152 |
| Number Of Beneficiaries Age Greater 84 | 59 |
| Number Of Female Beneficiaries | 416 |
| Number Of Male Beneficiaries | 255 |
| Number Of Non Hispanic White Beneficiaries | 596 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 56 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 494 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 177 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1168 |