| National Provider Identifier [NPI]: | 1255331914 |
| Last Name Of The Provider | WAGGONER |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 345 W BROAD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | COOKEVILLE |
| Zip Code Of The Provider | 385012331 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 7188 |
| Number Of Medicare Beneficiaries | 1006 |
| Total Submitted Charge Amount | 489144 |
| Total Medicare Allowed Amount | 452027.55 |
| Total Medicare Payment Amount | 306028.6 |
| Total Medicare Standardized Payment Amount | 345009.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 1503 |
| Number Of Medicare Beneficiaries With Drug Services | 434 |
| Total Drug Submitted ChargeAmount | 34638 |
| Total Drug Medicare AllowedAmount | 7567.78 |
| Total Drug Medicare PaymentAmount | 6897.33 |
| Total Drug Medicare Standardized Payment Amount | 6897.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 5685 |
| Number Of Medicare Beneficiaries With Medical Services | 1006 |
| Total Medical Submitted Charge Amount | 454506 |
| Total Medical Medicare Allowed Amount | 444459.77 |
| Total Medical Medicare Payment Amount | 299131.27 |
| Total Medical Medicare Standardized Payment Amount | 338112.63 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 91 |
| Number Of Beneficiaries Age 65 to 74 | 478 |
| Number Of Beneficiaries Age 75 to 84 | 322 |
| Number Of Beneficiaries Age Greater 84 | 115 |
| Number Of Female Beneficiaries | 518 |
| Number Of Male Beneficiaries | 488 |
| Number Of Non Hispanic White Beneficiaries | 968 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 937 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9854 |