| National Provider Identifier [NPI]: | 1164542346 |
| Last Name Of The Provider | FAGGARD |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1700 SPRING HILL AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MOBILE |
| Zip Code Of The Provider | 366041407 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 17835 |
| Number Of Medicare Beneficiaries | 821 |
| Total Submitted Charge Amount | 914071 |
| Total Medicare Allowed Amount | 664604.83 |
| Total Medicare Payment Amount | 501159.02 |
| Total Medicare Standardized Payment Amount | 515962.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 12484 |
| Number Of Medicare Beneficiaries With Drug Services | 244 |
| Total Drug Submitted ChargeAmount | 503352 |
| Total Drug Medicare AllowedAmount | 435736.02 |
| Total Drug Medicare PaymentAmount | 333016.81 |
| Total Drug Medicare Standardized Payment Amount | 333016.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 99 |
| Number Of Medical Services | 5351 |
| Number Of Medicare Beneficiaries With Medical Services | 820 |
| Total Medical Submitted Charge Amount | 410719 |
| Total Medical Medicare Allowed Amount | 228868.81 |
| Total Medical Medicare Payment Amount | 168142.21 |
| Total Medical Medicare Standardized Payment Amount | 182945.57 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 234 |
| Number Of Beneficiaries Age 65 to 74 | 252 |
| Number Of Beneficiaries Age 75 to 84 | 220 |
| Number Of Beneficiaries Age Greater 84 | 115 |
| Number Of Female Beneficiaries | 570 |
| Number Of Male Beneficiaries | 251 |
| Number Of Non Hispanic White Beneficiaries | 500 |
| Number Of Black or African American Beneficiaries | 309 |
| 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 | 530 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 291 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6953 |