| National Provider Identifier [NPI]: | 1477584423 |
| Last Name Of The Provider | OGAN |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1365B CLIFTON RD NE |
| Street Address 2 Of The Provider | SUITE B1400 |
| City Of The Provider | ATLANTA |
| Zip Code Of The Provider | 303221013 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 108 |
| Number Of Services | 2114 |
| Number Of Medicare Beneficiaries | 723 |
| Total Submitted Charge Amount | 1204154 |
| Total Medicare Allowed Amount | 254593.03 |
| Total Medicare Payment Amount | 190220.03 |
| Total Medicare Standardized Payment Amount | 190092.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 369 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 62584 |
| Total Drug Medicare AllowedAmount | 11436.54 |
| Total Drug Medicare PaymentAmount | 8824.83 |
| Total Drug Medicare Standardized Payment Amount | 8824.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 103 |
| Number Of Medical Services | 1745 |
| Number Of Medicare Beneficiaries With Medical Services | 723 |
| Total Medical Submitted Charge Amount | 1141570 |
| Total Medical Medicare Allowed Amount | 243156.49 |
| Total Medical Medicare Payment Amount | 181395.2 |
| Total Medical Medicare Standardized Payment Amount | 181267.55 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 169 |
| Number Of Beneficiaries Age 65 to 74 | 313 |
| Number Of Beneficiaries Age 75 to 84 | 185 |
| Number Of Beneficiaries Age Greater 84 | 56 |
| Number Of Female Beneficiaries | 222 |
| Number Of Male Beneficiaries | 501 |
| Number Of Non Hispanic White Beneficiaries | 485 |
| Number Of Black or African American Beneficiaries | 178 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 583 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 140 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 59 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 2.104 |