| National Provider Identifier [NPI]: | 1730186610 |
| Last Name Of The Provider | COLGAN |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 755 N 11TH ST |
| Street Address 2 Of The Provider | STE P2200 |
| City Of The Provider | BEAUMONT |
| Zip Code Of The Provider | 777021500 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 174 |
| Number Of Services | 31000 |
| Number Of Medicare Beneficiaries | 3592 |
| Total Submitted Charge Amount | 8874296.15 |
| Total Medicare Allowed Amount | 1883155.69 |
| Total Medicare Payment Amount | 1436345.76 |
| Total Medicare Standardized Payment Amount | 1510124.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 16648 |
| Number Of Medicare Beneficiaries With Drug Services | 653 |
| Total Drug Submitted ChargeAmount | 127816 |
| Total Drug Medicare AllowedAmount | 10666.12 |
| Total Drug Medicare PaymentAmount | 8290.34 |
| Total Drug Medicare Standardized Payment Amount | 8290.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 168 |
| Number Of Medical Services | 14352 |
| Number Of Medicare Beneficiaries With Medical Services | 3591 |
| Total Medical Submitted Charge Amount | 8746480.15 |
| Total Medical Medicare Allowed Amount | 1872489.57 |
| Total Medical Medicare Payment Amount | 1428055.42 |
| Total Medical Medicare Standardized Payment Amount | 1501834.53 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 356 |
| Number Of Beneficiaries Age 65 to 74 | 1361 |
| Number Of Beneficiaries Age 75 to 84 | 1257 |
| Number Of Beneficiaries Age Greater 84 | 618 |
| Number Of Female Beneficiaries | 1916 |
| Number Of Male Beneficiaries | 1676 |
| Number Of Non Hispanic White Beneficiaries | 3086 |
| Number Of Black or African American Beneficiaries | 402 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 68 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3061 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 531 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5615 |