| National Provider Identifier [NPI]: | 1235324781 |
| Last Name Of The Provider | OGLE |
| First Name Of The Provider | KIM |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1625 MAPLE LANE |
| Street Address 2 Of The Provider | DULUTH CLINIC-ASHLAND |
| City Of The Provider | ASHLAND |
| Zip Code Of The Provider | 54806 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 197 |
| Number Of Services | 9370 |
| Number Of Medicare Beneficiaries | 992 |
| Total Submitted Charge Amount | 809282 |
| Total Medicare Allowed Amount | 258426.96 |
| Total Medicare Payment Amount | 196763.77 |
| Total Medicare Standardized Payment Amount | 202497.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 39 |
| Number Of Drug Services | 3230 |
| Number Of Medicare Beneficiaries With Drug Services | 132 |
| Total Drug Submitted ChargeAmount | 129604.5 |
| Total Drug Medicare AllowedAmount | 53413.74 |
| Total Drug Medicare PaymentAmount | 42209.06 |
| Total Drug Medicare Standardized Payment Amount | 42209.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 158 |
| Number Of Medical Services | 6140 |
| Number Of Medicare Beneficiaries With Medical Services | 992 |
| Total Medical Submitted Charge Amount | 679677.5 |
| Total Medical Medicare Allowed Amount | 205013.22 |
| Total Medical Medicare Payment Amount | 154554.71 |
| Total Medical Medicare Standardized Payment Amount | 160288 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 135 |
| Number Of Beneficiaries Age 65 to 74 | 362 |
| Number Of Beneficiaries Age 75 to 84 | 301 |
| Number Of Beneficiaries Age Greater 84 | 194 |
| Number Of Female Beneficiaries | 619 |
| Number Of Male Beneficiaries | 373 |
| Number Of Non Hispanic White Beneficiaries | 896 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 77 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 722 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 270 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3227 |