| National Provider Identifier [NPI]: | 1912929068 |
| Last Name Of The Provider | FAGAN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11 MEDICAL PARK |
| Street Address 2 Of The Provider | |
| City Of The Provider | VALLEY |
| Zip Code Of The Provider | 368543665 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 5054 |
| Number Of Medicare Beneficiaries | 797 |
| Total Submitted Charge Amount | 311171.6 |
| Total Medicare Allowed Amount | 275001.8 |
| Total Medicare Payment Amount | 200627.4 |
| Total Medicare Standardized Payment Amount | 218189.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 373 |
| Number Of Medicare Beneficiaries With Drug Services | 261 |
| Total Drug Submitted ChargeAmount | 6025.57 |
| Total Drug Medicare AllowedAmount | 5558.01 |
| Total Drug Medicare PaymentAmount | 5347.92 |
| Total Drug Medicare Standardized Payment Amount | 5347.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 4681 |
| Number Of Medicare Beneficiaries With Medical Services | 797 |
| Total Medical Submitted Charge Amount | 305146.03 |
| Total Medical Medicare Allowed Amount | 269443.79 |
| Total Medical Medicare Payment Amount | 195279.48 |
| Total Medical Medicare Standardized Payment Amount | 212841.26 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 143 |
| Number Of Beneficiaries Age 65 to 74 | 286 |
| Number Of Beneficiaries Age 75 to 84 | 246 |
| Number Of Beneficiaries Age Greater 84 | 122 |
| Number Of Female Beneficiaries | 455 |
| Number Of Male Beneficiaries | 342 |
| Number Of Non Hispanic White Beneficiaries | 564 |
| 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 | 558 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 239 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3599 |