| National Provider Identifier [NPI]: | 1700092319 |
| Last Name Of The Provider | HERROD |
| First Name Of The Provider | HENRY |
| 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 | 5444 GREEN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MURRAY |
| Zip Code Of The Provider | 841235632 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 173 |
| Number Of Services | 3183 |
| Number Of Medicare Beneficiaries | 1365 |
| Total Submitted Charge Amount | 520312.92 |
| Total Medicare Allowed Amount | 117187.42 |
| Total Medicare Payment Amount | 89384.48 |
| Total Medicare Standardized Payment Amount | 94543.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 1385 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 4540.02 |
| Total Drug Medicare AllowedAmount | 819.61 |
| Total Drug Medicare PaymentAmount | 642.6 |
| Total Drug Medicare Standardized Payment Amount | 642.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 164 |
| Number Of Medical Services | 1798 |
| Number Of Medicare Beneficiaries With Medical Services | 1365 |
| Total Medical Submitted Charge Amount | 515772.9 |
| Total Medical Medicare Allowed Amount | 116367.81 |
| Total Medical Medicare Payment Amount | 88741.88 |
| Total Medical Medicare Standardized Payment Amount | 93900.6 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 245 |
| Number Of Beneficiaries Age 65 to 74 | 498 |
| Number Of Beneficiaries Age 75 to 84 | 412 |
| Number Of Beneficiaries Age Greater 84 | 210 |
| Number Of Female Beneficiaries | 757 |
| Number Of Male Beneficiaries | 608 |
| Number Of Non Hispanic White Beneficiaries | 1214 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 34 |
| Number Of Hispanic Beneficiaries | 75 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1127 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 238 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5988 |