| National Provider Identifier [NPI]: | 1740240332 |
| Last Name Of The Provider | BROGAN |
| First Name Of The Provider | MARTHA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 111 S GRANT AVE |
| Street Address 2 Of The Provider | 3RD FLOOR RADIOLOGY DEPT |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 432154701 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 142 |
| Number Of Services | 4274 |
| Number Of Medicare Beneficiaries | 3122 |
| Total Submitted Charge Amount | 750797 |
| Total Medicare Allowed Amount | 169826.67 |
| Total Medicare Payment Amount | 126207.6 |
| Total Medicare Standardized Payment Amount | 131078.11 |
| 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 | 142 |
| Number Of Medical Services | 4274 |
| Number Of Medicare Beneficiaries With Medical Services | 3122 |
| Total Medical Submitted Charge Amount | 750797 |
| Total Medical Medicare Allowed Amount | 169826.67 |
| Total Medical Medicare Payment Amount | 126207.6 |
| Total Medical Medicare Standardized Payment Amount | 131078.11 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 975 |
| Number Of Beneficiaries Age 65 to 74 | 998 |
| Number Of Beneficiaries Age 75 to 84 | 709 |
| Number Of Beneficiaries Age Greater 84 | 440 |
| Number Of Female Beneficiaries | 1852 |
| Number Of Male Beneficiaries | 1270 |
| Number Of Non Hispanic White Beneficiaries | 2701 |
| Number Of Black or African American Beneficiaries | 354 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1829 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1293 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8083 |