| National Provider Identifier [NPI]: | 1144223306 |
| Last Name Of The Provider | DONOVAN |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7695 POPLAR PIKE |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | GERMANTOWN |
| Zip Code Of The Provider | 381385947 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 192 |
| Number Of Services | 6008 |
| Number Of Medicare Beneficiaries | 4168 |
| Total Submitted Charge Amount | 873750 |
| Total Medicare Allowed Amount | 179604.2 |
| Total Medicare Payment Amount | 135469.73 |
| Total Medicare Standardized Payment Amount | 144891.93 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 1088 |
| Number Of Beneficiaries Age 65 to 74 | 1416 |
| Number Of Beneficiaries Age 75 to 84 | 1101 |
| Number Of Beneficiaries Age Greater 84 | 563 |
| Number Of Female Beneficiaries | 2532 |
| Number Of Male Beneficiaries | 1636 |
| Number Of Non Hispanic White Beneficiaries | 2378 |
| Number Of Black or African American Beneficiaries | 1733 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2661 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1507 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.0906 |