| National Provider Identifier [NPI]: | 1811953177 |
| Last Name Of The Provider | SHOWN |
| First Name Of The Provider | TIM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4901 E JOHNSON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | JONESBORO |
| Zip Code Of The Provider | 724018417 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 8221 |
| Number Of Medicare Beneficiaries | 577 |
| Total Submitted Charge Amount | 308869.15 |
| Total Medicare Allowed Amount | 187405.94 |
| Total Medicare Payment Amount | 129762.05 |
| Total Medicare Standardized Payment Amount | 144933.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 19 |
| Number Of Drug Services | 2739 |
| Number Of Medicare Beneficiaries With Drug Services | 389 |
| Total Drug Submitted ChargeAmount | 36745.65 |
| Total Drug Medicare AllowedAmount | 13308.08 |
| Total Drug Medicare PaymentAmount | 11007.38 |
| Total Drug Medicare Standardized Payment Amount | 11007.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 80 |
| Number Of Medical Services | 5482 |
| Number Of Medicare Beneficiaries With Medical Services | 576 |
| Total Medical Submitted Charge Amount | 272123.5 |
| Total Medical Medicare Allowed Amount | 174097.86 |
| Total Medical Medicare Payment Amount | 118754.67 |
| Total Medical Medicare Standardized Payment Amount | 133925.7 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 137 |
| Number Of Beneficiaries Age 65 to 74 | 282 |
| Number Of Beneficiaries Age 75 to 84 | 136 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 331 |
| Number Of Male Beneficiaries | 246 |
| Number Of Non Hispanic White Beneficiaries | 549 |
| 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 | 489 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 88 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9111 |