| National Provider Identifier [NPI]: | 1679779979 |
| Last Name Of The Provider | OGHLAKIAN |
| First Name Of The Provider | GERARD |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2115 S FREMONT AVE |
| Street Address 2 Of The Provider | STE 4300 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 658042239 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 3639 |
| Number Of Medicare Beneficiaries | 1997 |
| Total Submitted Charge Amount | 939421 |
| Total Medicare Allowed Amount | 211076.48 |
| Total Medicare Payment Amount | 157412.73 |
| Total Medicare Standardized Payment Amount | 166286.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 3639 |
| Number Of Medicare Beneficiaries With Medical Services | 1997 |
| Total Medical Submitted Charge Amount | 939421 |
| Total Medical Medicare Allowed Amount | 211076.48 |
| Total Medical Medicare Payment Amount | 157412.73 |
| Total Medical Medicare Standardized Payment Amount | 166286.37 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 313 |
| Number Of Beneficiaries Age 65 to 74 | 725 |
| Number Of Beneficiaries Age 75 to 84 | 646 |
| Number Of Beneficiaries Age Greater 84 | 313 |
| Number Of Female Beneficiaries | 1027 |
| Number Of Male Beneficiaries | 970 |
| Number Of Non Hispanic White Beneficiaries | 1927 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1576 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 421 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.601 |