| National Provider Identifier [NPI]: | 1972720928 |
| Last Name Of The Provider | OGLESBY |
| First Name Of The Provider | TAKIA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7351 OLD MOON RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 319097291 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 6429 |
| Number Of Medicare Beneficiaries | 698 |
| Total Submitted Charge Amount | 2310471.31 |
| Total Medicare Allowed Amount | 440969.74 |
| Total Medicare Payment Amount | 348919.78 |
| Total Medicare Standardized Payment Amount | 369628.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 291 |
| Number Of Medicare Beneficiaries With Drug Services | 69 |
| Total Drug Submitted ChargeAmount | 56600 |
| Total Drug Medicare AllowedAmount | 16509.04 |
| Total Drug Medicare PaymentAmount | 12313.93 |
| Total Drug Medicare Standardized Payment Amount | 12313.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 6138 |
| Number Of Medicare Beneficiaries With Medical Services | 698 |
| Total Medical Submitted Charge Amount | 2253871.31 |
| Total Medical Medicare Allowed Amount | 424460.7 |
| Total Medical Medicare Payment Amount | 336605.85 |
| Total Medical Medicare Standardized Payment Amount | 357315 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 400 |
| Number Of Beneficiaries Age 65 to 74 | 178 |
| Number Of Beneficiaries Age 75 to 84 | 101 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 447 |
| Number Of Male Beneficiaries | 251 |
| Number Of Non Hispanic White Beneficiaries | 460 |
| Number Of Black or African American Beneficiaries | 207 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 512 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 186 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.3689 |