| National Provider Identifier [NPI]: | 1265431613 |
| Last Name Of The Provider | HENRY |
| First Name Of The Provider | ERNEST |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D., MRCPI |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | CARROLL ST. & TATE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LEBANON |
| Zip Code Of The Provider | 24266 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 23868 |
| Number Of Medicare Beneficiaries | 691 |
| Total Submitted Charge Amount | 646909 |
| Total Medicare Allowed Amount | 420442.31 |
| Total Medicare Payment Amount | 311379.45 |
| Total Medicare Standardized Payment Amount | 316278.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 20627 |
| Number Of Medicare Beneficiaries With Drug Services | 141 |
| Total Drug Submitted ChargeAmount | 121782 |
| Total Drug Medicare AllowedAmount | 78211 |
| Total Drug Medicare PaymentAmount | 61406.55 |
| Total Drug Medicare Standardized Payment Amount | 61406.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 3241 |
| Number Of Medicare Beneficiaries With Medical Services | 691 |
| Total Medical Submitted Charge Amount | 525127 |
| Total Medical Medicare Allowed Amount | 342231.31 |
| Total Medical Medicare Payment Amount | 249972.9 |
| Total Medical Medicare Standardized Payment Amount | 254872.05 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 145 |
| Number Of Beneficiaries Age 65 to 74 | 237 |
| Number Of Beneficiaries Age 75 to 84 | 225 |
| Number Of Beneficiaries Age Greater 84 | 84 |
| Number Of Female Beneficiaries | 342 |
| Number Of Male Beneficiaries | 349 |
| Number Of Non Hispanic White Beneficiaries | 673 |
| 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 | 537 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 154 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 59 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 2.5683 |