| National Provider Identifier [NPI]: | 1114923547 |
| Last Name Of The Provider | THAGGARD |
| First Name Of The Provider | W |
| 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 | 2024 15TH ST FL 2 |
| Street Address 2 Of The Provider | |
| City Of The Provider | MERIDIAN |
| Zip Code Of The Provider | 393014130 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gastroenterology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 2663 |
| Number Of Medicare Beneficiaries | 916 |
| Total Submitted Charge Amount | 277475.38 |
| Total Medicare Allowed Amount | 242276.63 |
| Total Medicare Payment Amount | 180671.78 |
| Total Medicare Standardized Payment Amount | 198821.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 12 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 348.62 |
| Total Drug Medicare AllowedAmount | 340.37 |
| Total Drug Medicare PaymentAmount | 262.65 |
| Total Drug Medicare Standardized Payment Amount | 262.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 96 |
| Number Of Medical Services | 2651 |
| Number Of Medicare Beneficiaries With Medical Services | 916 |
| Total Medical Submitted Charge Amount | 277126.76 |
| Total Medical Medicare Allowed Amount | 241936.26 |
| Total Medical Medicare Payment Amount | 180409.13 |
| Total Medical Medicare Standardized Payment Amount | 198558.67 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 145 |
| Number Of Beneficiaries Age 65 to 74 | 370 |
| Number Of Beneficiaries Age 75 to 84 | 309 |
| Number Of Beneficiaries Age Greater 84 | 92 |
| Number Of Female Beneficiaries | 548 |
| Number Of Male Beneficiaries | 368 |
| Number Of Non Hispanic White Beneficiaries | 719 |
| Number Of Black or African American Beneficiaries | 182 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 673 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 243 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4112 |