| National Provider Identifier [NPI]: | 1750339529 |
| Last Name Of The Provider | DONAHUE |
| First Name Of The Provider | DONALD |
| 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 | 1301 SUNSET DR |
| Street Address 2 Of The Provider | STE 3 |
| City Of The Provider | JOHNSON CITY |
| Zip Code Of The Provider | 376047906 |
| 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 | 152 |
| Number Of Services | 2836 |
| Number Of Medicare Beneficiaries | 2123 |
| Total Submitted Charge Amount | 372476 |
| Total Medicare Allowed Amount | 94206.65 |
| Total Medicare Payment Amount | 70434.57 |
| Total Medicare Standardized Payment Amount | 76038.61 |
| 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 | 152 |
| Number Of Medical Services | 2836 |
| Number Of Medicare Beneficiaries With Medical Services | 2123 |
| Total Medical Submitted Charge Amount | 372476 |
| Total Medical Medicare Allowed Amount | 94206.65 |
| Total Medical Medicare Payment Amount | 70434.57 |
| Total Medical Medicare Standardized Payment Amount | 76038.61 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 468 |
| Number Of Beneficiaries Age 65 to 74 | 745 |
| Number Of Beneficiaries Age 75 to 84 | 570 |
| Number Of Beneficiaries Age Greater 84 | 340 |
| Number Of Female Beneficiaries | 1232 |
| Number Of Male Beneficiaries | 891 |
| Number Of Non Hispanic White Beneficiaries | 2067 |
| Number Of Black or African American Beneficiaries | 21 |
| 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 | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1415 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 708 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.7871 |