| National Provider Identifier [NPI]: | 1518932839 |
| Last Name Of The Provider | MOGOR |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1150 N HUDSON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOWELL |
| Zip Code Of The Provider | 493311000 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 2002 |
| Number Of Medicare Beneficiaries | 389 |
| Total Submitted Charge Amount | 162093 |
| Total Medicare Allowed Amount | 86287.58 |
| Total Medicare Payment Amount | 63082.76 |
| Total Medicare Standardized Payment Amount | 66090.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 173 |
| Number Of Medicare Beneficiaries With Drug Services | 89 |
| Total Drug Submitted ChargeAmount | 5613 |
| Total Drug Medicare AllowedAmount | 3769.11 |
| Total Drug Medicare PaymentAmount | 3656.12 |
| Total Drug Medicare Standardized Payment Amount | 3656.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 1829 |
| Number Of Medicare Beneficiaries With Medical Services | 388 |
| Total Medical Submitted Charge Amount | 156480 |
| Total Medical Medicare Allowed Amount | 82518.47 |
| Total Medical Medicare Payment Amount | 59426.64 |
| Total Medical Medicare Standardized Payment Amount | 62433.98 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 78 |
| Number Of Beneficiaries Age 65 to 74 | 120 |
| Number Of Beneficiaries Age 75 to 84 | 120 |
| Number Of Beneficiaries Age Greater 84 | 71 |
| Number Of Female Beneficiaries | 210 |
| Number Of Male Beneficiaries | 179 |
| Number Of Non Hispanic White Beneficiaries | 352 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 295 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 94 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6118 |