| National Provider Identifier [NPI]: | 1730100249 |
| Last Name Of The Provider | HENDERSON |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 315 HOLTON AVE STE 102 |
| Street Address 2 Of The Provider | |
| City Of The Provider | YAKIMA |
| Zip Code Of The Provider | 989023240 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 213 |
| Number Of Services | 7757 |
| Number Of Medicare Beneficiaries | 4811 |
| Total Submitted Charge Amount | 1094165.6 |
| Total Medicare Allowed Amount | 244480.44 |
| Total Medicare Payment Amount | 185624.22 |
| Total Medicare Standardized Payment Amount | 190154.19 |
| 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 | 213 |
| Number Of Medical Services | 7757 |
| Number Of Medicare Beneficiaries With Medical Services | 4811 |
| Total Medical Submitted Charge Amount | 1094165.6 |
| Total Medical Medicare Allowed Amount | 244480.44 |
| Total Medical Medicare Payment Amount | 185624.22 |
| Total Medical Medicare Standardized Payment Amount | 190154.19 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 869 |
| Number Of Beneficiaries Age 65 to 74 | 1811 |
| Number Of Beneficiaries Age 75 to 84 | 1392 |
| Number Of Beneficiaries Age Greater 84 | 739 |
| Number Of Female Beneficiaries | 3013 |
| Number Of Male Beneficiaries | 1798 |
| Number Of Non Hispanic White Beneficiaries | 4027 |
| Number Of Black or African American Beneficiaries | 52 |
| Number Of AsianPacific Islander Beneficiaries | 34 |
| Number Of Hispanic Beneficiaries | 485 |
| Number Of American Indian Alaska Native Beneficiaries | 180 |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3445 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1366 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3429 |