| National Provider Identifier [NPI]: | 1760421549 |
| Last Name Of The Provider | COLGAN |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 29 SOUTH PACA STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 21201 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 737 |
| Number Of Medicare Beneficiaries | 357 |
| Total Submitted Charge Amount | 98014.57 |
| Total Medicare Allowed Amount | 54691.47 |
| Total Medicare Payment Amount | 39078.68 |
| Total Medicare Standardized Payment Amount | 36865.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 43 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 797.72 |
| Total Drug Medicare AllowedAmount | 599.16 |
| Total Drug Medicare PaymentAmount | 578.04 |
| Total Drug Medicare Standardized Payment Amount | 578.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 694 |
| Number Of Medicare Beneficiaries With Medical Services | 357 |
| Total Medical Submitted Charge Amount | 97216.85 |
| Total Medical Medicare Allowed Amount | 54092.31 |
| Total Medical Medicare Payment Amount | 38500.64 |
| Total Medical Medicare Standardized Payment Amount | 36287.45 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 145 |
| Number Of Beneficiaries Age 65 to 74 | 138 |
| Number Of Beneficiaries Age 75 to 84 | 54 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 206 |
| Number Of Male Beneficiaries | 151 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 218 |
| 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 | 185 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 172 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3692 |