| National Provider Identifier [NPI]: | 1467501999 |
| Last Name Of The Provider | MCDONALD |
| First Name Of The Provider | SHANNON |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 317 SEVEN SPRINGS WAY |
| Street Address 2 Of The Provider | SUITE 104 |
| City Of The Provider | BRENTWOOD |
| Zip Code Of The Provider | 37027 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 331 |
| Number Of Medicare Beneficiaries | 57 |
| Total Submitted Charge Amount | 46550 |
| Total Medicare Allowed Amount | 21146.42 |
| Total Medicare Payment Amount | 15710.46 |
| Total Medicare Standardized Payment Amount | 16888.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 1604 |
| Total Drug Medicare AllowedAmount | 638.93 |
| Total Drug Medicare PaymentAmount | 626.17 |
| Total Drug Medicare Standardized Payment Amount | 626.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 305 |
| Number Of Medicare Beneficiaries With Medical Services | 57 |
| Total Medical Submitted Charge Amount | 44946 |
| Total Medical Medicare Allowed Amount | 20507.49 |
| Total Medical Medicare Payment Amount | 15084.29 |
| Total Medical Medicare Standardized Payment Amount | 16262.35 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 38 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 42 |
| Number Of Male Beneficiaries | 15 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7281 |