| National Provider Identifier [NPI]: | 1780689893 |
| Last Name Of The Provider | HENRY |
| First Name Of The Provider | RUSSELL |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 911 VERRET ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUMA |
| Zip Code Of The Provider | 703604637 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 10074 |
| Number Of Medicare Beneficiaries | 1535 |
| Total Submitted Charge Amount | 662644.38 |
| Total Medicare Allowed Amount | 472131.32 |
| Total Medicare Payment Amount | 347456.98 |
| Total Medicare Standardized Payment Amount | 375209.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 1035 |
| Number Of Medicare Beneficiaries With Drug Services | 400 |
| Total Drug Submitted ChargeAmount | 16100 |
| Total Drug Medicare AllowedAmount | 11940.9 |
| Total Drug Medicare PaymentAmount | 11595.8 |
| Total Drug Medicare Standardized Payment Amount | 11595.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 9039 |
| Number Of Medicare Beneficiaries With Medical Services | 1535 |
| Total Medical Submitted Charge Amount | 646544.38 |
| Total Medical Medicare Allowed Amount | 460190.42 |
| Total Medical Medicare Payment Amount | 335861.18 |
| Total Medical Medicare Standardized Payment Amount | 363614.15 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 186 |
| Number Of Beneficiaries Age 65 to 74 | 539 |
| Number Of Beneficiaries Age 75 to 84 | 553 |
| Number Of Beneficiaries Age Greater 84 | 257 |
| Number Of Female Beneficiaries | 806 |
| Number Of Male Beneficiaries | 729 |
| Number Of Non Hispanic White Beneficiaries | 1372 |
| Number Of Black or African American Beneficiaries | 114 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1269 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 266 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3212 |