| National Provider Identifier [NPI]: | 1689865636 |
| Last Name Of The Provider | OGLES |
| First Name Of The Provider | MITCHELL |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3 DOCTORS PARK |
| Street Address 2 Of The Provider | |
| City Of The Provider | CAPE GIRARDEAU |
| Zip Code Of The Provider | 637034927 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 129 |
| Number Of Services | 4885 |
| Number Of Medicare Beneficiaries | 609 |
| Total Submitted Charge Amount | 1390333.59 |
| Total Medicare Allowed Amount | 339758.54 |
| Total Medicare Payment Amount | 257067.07 |
| Total Medicare Standardized Payment Amount | 275934.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 404 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 160894.08 |
| Total Drug Medicare AllowedAmount | 36383.48 |
| Total Drug Medicare PaymentAmount | 27435.97 |
| Total Drug Medicare Standardized Payment Amount | 27435.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 125 |
| Number Of Medical Services | 4481 |
| Number Of Medicare Beneficiaries With Medical Services | 609 |
| Total Medical Submitted Charge Amount | 1229439.51 |
| Total Medical Medicare Allowed Amount | 303375.06 |
| Total Medical Medicare Payment Amount | 229631.1 |
| Total Medical Medicare Standardized Payment Amount | 248498.88 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 90 |
| Number Of Beneficiaries Age 65 to 74 | 261 |
| Number Of Beneficiaries Age 75 to 84 | 168 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 224 |
| Number Of Male Beneficiaries | 385 |
| Number Of Non Hispanic White Beneficiaries | 584 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 484 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 125 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3704 |