| National Provider Identifier [NPI]: | 1356456420 |
| Last Name Of The Provider | HENNES |
| First Name Of The Provider | MAGDA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5323 HARRY HINES BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 753907201 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 1101 |
| Number Of Medicare Beneficiaries | 374 |
| Total Submitted Charge Amount | 189400 |
| Total Medicare Allowed Amount | 71286.03 |
| Total Medicare Payment Amount | 50958.36 |
| Total Medicare Standardized Payment Amount | 51236.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 164 |
| Number Of Medicare Beneficiaries With Drug Services | 117 |
| Total Drug Submitted ChargeAmount | 15104 |
| Total Drug Medicare AllowedAmount | 5839.67 |
| Total Drug Medicare PaymentAmount | 5703.05 |
| Total Drug Medicare Standardized Payment Amount | 5703.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 937 |
| Number Of Medicare Beneficiaries With Medical Services | 374 |
| Total Medical Submitted Charge Amount | 174296 |
| Total Medical Medicare Allowed Amount | 65446.36 |
| Total Medical Medicare Payment Amount | 45255.31 |
| Total Medical Medicare Standardized Payment Amount | 45533.91 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 193 |
| Number Of Beneficiaries Age 75 to 84 | 103 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 261 |
| Number Of Male Beneficiaries | 113 |
| Number Of Non Hispanic White Beneficiaries | 265 |
| Number Of Black or African American Beneficiaries | 70 |
| 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 | 295 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 79 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2777 |