| National Provider Identifier [NPI]: | 1720083066 |
| Last Name Of The Provider | HENTHORN |
| First Name Of The Provider | RAYMOND |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 316 5TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MARIETTA |
| Zip Code Of The Provider | 457503027 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 1196 |
| Number Of Medicare Beneficiaries | 474 |
| Total Submitted Charge Amount | 130080 |
| Total Medicare Allowed Amount | 54465.93 |
| Total Medicare Payment Amount | 35229.32 |
| Total Medicare Standardized Payment Amount | 40363.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 284 |
| Number Of Medicare Beneficiaries With Drug Services | 145 |
| Total Drug Submitted ChargeAmount | 6930 |
| Total Drug Medicare AllowedAmount | 1351.4 |
| Total Drug Medicare PaymentAmount | 950.04 |
| Total Drug Medicare Standardized Payment Amount | 950.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 912 |
| Number Of Medicare Beneficiaries With Medical Services | 474 |
| Total Medical Submitted Charge Amount | 123150 |
| Total Medical Medicare Allowed Amount | 53114.53 |
| Total Medical Medicare Payment Amount | 34279.28 |
| Total Medical Medicare Standardized Payment Amount | 39413.06 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 157 |
| Number Of Beneficiaries Age 65 to 74 | 168 |
| Number Of Beneficiaries Age 75 to 84 | 103 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 289 |
| Number Of Male Beneficiaries | 185 |
| 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 | 327 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 147 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9975 |