| National Provider Identifier [NPI]: | 1659352011 |
| Last Name Of The Provider | THAGGARD |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1203 24TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MERIDIAN |
| Zip Code Of The Provider | 393013926 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 257 |
| Number Of Services | 8600 |
| Number Of Medicare Beneficiaries | 4718 |
| Total Submitted Charge Amount | 1266910 |
| Total Medicare Allowed Amount | 239163.03 |
| Total Medicare Payment Amount | 181450.32 |
| Total Medicare Standardized Payment Amount | 192991.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 197 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 985 |
| Total Drug Medicare AllowedAmount | 387.69 |
| Total Drug Medicare PaymentAmount | 303.97 |
| Total Drug Medicare Standardized Payment Amount | 303.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 256 |
| Number Of Medical Services | 8403 |
| Number Of Medicare Beneficiaries With Medical Services | 4718 |
| Total Medical Submitted Charge Amount | 1265925 |
| Total Medical Medicare Allowed Amount | 238775.34 |
| Total Medical Medicare Payment Amount | 181146.35 |
| Total Medical Medicare Standardized Payment Amount | 192687.76 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 1005 |
| Number Of Beneficiaries Age 65 to 74 | 1634 |
| Number Of Beneficiaries Age 75 to 84 | 1375 |
| Number Of Beneficiaries Age Greater 84 | 704 |
| Number Of Female Beneficiaries | 2885 |
| Number Of Male Beneficiaries | 1833 |
| Number Of Non Hispanic White Beneficiaries | 3259 |
| Number Of Black or African American Beneficiaries | 1360 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 72 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2973 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1745 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6287 |