| National Provider Identifier [NPI]: | 1992730915 |
| Last Name Of The Provider | HINES |
| First Name Of The Provider | HENRY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 803 POPLAR ST |
| Street Address 2 Of The Provider | MURRAY-CALLOWAY COUNTY HOSPITAL |
| City Of The Provider | MURRAY |
| Zip Code Of The Provider | 42071 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 193 |
| Number Of Services | 9375 |
| Number Of Medicare Beneficiaries | 5262 |
| Total Submitted Charge Amount | 966818.11 |
| Total Medicare Allowed Amount | 283029.94 |
| Total Medicare Payment Amount | 209136.26 |
| Total Medicare Standardized Payment Amount | 225067.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 193 |
| Number Of Medical Services | 9375 |
| Number Of Medicare Beneficiaries With Medical Services | 5262 |
| Total Medical Submitted Charge Amount | 966818.11 |
| Total Medical Medicare Allowed Amount | 283029.94 |
| Total Medical Medicare Payment Amount | 209136.26 |
| Total Medical Medicare Standardized Payment Amount | 225067.61 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 1020 |
| Number Of Beneficiaries Age 65 to 74 | 1988 |
| Number Of Beneficiaries Age 75 to 84 | 1560 |
| Number Of Beneficiaries Age Greater 84 | 694 |
| Number Of Female Beneficiaries | 3057 |
| Number Of Male Beneficiaries | 2205 |
| Number Of Non Hispanic White Beneficiaries | 4987 |
| Number Of Black or African American Beneficiaries | 212 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4032 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1230 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3744 |