| National Provider Identifier [NPI]: | 1306819834 |
| Last Name Of The Provider | MCDONALD |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | C2102 A MCN |
| Street Address 2 Of The Provider | 1161 21ST AVE S |
| City Of The Provider | NASHVILLE |
| Zip Code Of The Provider | 372320001 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 1520 |
| Number Of Medicare Beneficiaries | 763 |
| Total Submitted Charge Amount | 268740 |
| Total Medicare Allowed Amount | 57250.53 |
| Total Medicare Payment Amount | 43082.34 |
| Total Medicare Standardized Payment Amount | 43208.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 1520 |
| Number Of Medicare Beneficiaries With Medical Services | 763 |
| Total Medical Submitted Charge Amount | 268740 |
| Total Medical Medicare Allowed Amount | 57250.53 |
| Total Medical Medicare Payment Amount | 43082.34 |
| Total Medical Medicare Standardized Payment Amount | 43208.6 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 173 |
| Number Of Beneficiaries Age 65 to 74 | 390 |
| Number Of Beneficiaries Age 75 to 84 | 172 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 354 |
| Number Of Male Beneficiaries | 409 |
| Number Of Non Hispanic White Beneficiaries | 691 |
| Number Of Black or African American Beneficiaries | 48 |
| 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 | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 645 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 118 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.6875 |