| National Provider Identifier [NPI]: | 1285631721 |
| Last Name Of The Provider | COLGLAZIER |
| First Name Of The Provider | CLIFFORD |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 945 WASHINGTON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRANT |
| Zip Code Of The Provider | 691403044 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 3216 |
| Number Of Medicare Beneficiaries | 599 |
| Total Submitted Charge Amount | 163934.38 |
| Total Medicare Allowed Amount | 159525.35 |
| Total Medicare Payment Amount | 107305.51 |
| Total Medicare Standardized Payment Amount | 120083.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 372 |
| Number Of Medicare Beneficiaries With Drug Services | 288 |
| Total Drug Submitted ChargeAmount | 10169.49 |
| Total Drug Medicare AllowedAmount | 8232.2 |
| Total Drug Medicare PaymentAmount | 8010.93 |
| Total Drug Medicare Standardized Payment Amount | 8010.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 2844 |
| Number Of Medicare Beneficiaries With Medical Services | 599 |
| Total Medical Submitted Charge Amount | 153764.89 |
| Total Medical Medicare Allowed Amount | 151293.15 |
| Total Medical Medicare Payment Amount | 99294.58 |
| Total Medical Medicare Standardized Payment Amount | 112072.9 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 277 |
| Number Of Beneficiaries Age 75 to 84 | 176 |
| Number Of Beneficiaries Age Greater 84 | 114 |
| Number Of Female Beneficiaries | 305 |
| Number Of Male Beneficiaries | 294 |
| Number Of Non Hispanic White Beneficiaries | 576 |
| 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 | 547 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 6 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 16 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9165 |