| National Provider Identifier [NPI]: | 1093709560 |
| Last Name Of The Provider | HENRICH |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 250 S CRESCENT DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MASON CITY |
| Zip Code Of The Provider | 504012926 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 5863 |
| Number Of Medicare Beneficiaries | 1281 |
| Total Submitted Charge Amount | 778734 |
| Total Medicare Allowed Amount | 313235.4 |
| Total Medicare Payment Amount | 222320.63 |
| Total Medicare Standardized Payment Amount | 242570.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 655 |
| Number Of Medicare Beneficiaries With Drug Services | 127 |
| Total Drug Submitted ChargeAmount | 1965 |
| Total Drug Medicare AllowedAmount | 1165.86 |
| Total Drug Medicare PaymentAmount | 822.54 |
| Total Drug Medicare Standardized Payment Amount | 822.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 5208 |
| Number Of Medicare Beneficiaries With Medical Services | 1281 |
| Total Medical Submitted Charge Amount | 776769 |
| Total Medical Medicare Allowed Amount | 312069.54 |
| Total Medical Medicare Payment Amount | 221498.09 |
| Total Medical Medicare Standardized Payment Amount | 241747.82 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 116 |
| Number Of Beneficiaries Age 65 to 74 | 337 |
| Number Of Beneficiaries Age 75 to 84 | 443 |
| Number Of Beneficiaries Age Greater 84 | 385 |
| Number Of Female Beneficiaries | 815 |
| Number Of Male Beneficiaries | 466 |
| Number Of Non Hispanic White Beneficiaries | 1257 |
| 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 | 1016 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 265 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.3368 |