National Provider Identifier [NPI]: |
1306995527 |
Last Name Of The Provider |
HENDERSON |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
531 POLK 77 |
Street Address 2 Of The Provider |
|
City Of The Provider |
MENA |
Zip Code Of The Provider |
719537848 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
1968 |
Number Of Medicare Beneficiaries |
523 |
Total Submitted Charge Amount |
320169.5 |
Total Medicare Allowed Amount |
189063.7 |
Total Medicare Payment Amount |
144347.36 |
Total Medicare Standardized Payment Amount |
154800.3 |
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 |
24 |
Number Of Medical Services |
1968 |
Number Of Medicare Beneficiaries With Medical Services |
523 |
Total Medical Submitted Charge Amount |
320169.5 |
Total Medical Medicare Allowed Amount |
189063.7 |
Total Medical Medicare Payment Amount |
144347.36 |
Total Medical Medicare Standardized Payment Amount |
154800.3 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
163 |
Number Of Beneficiaries Age 75 to 84 |
160 |
Number Of Beneficiaries Age Greater 84 |
125 |
Number Of Female Beneficiaries |
315 |
Number Of Male Beneficiaries |
208 |
Number Of Non Hispanic White Beneficiaries |
505 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
306 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
217 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
35 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
49 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.5528 |