| National Provider Identifier [NPI]: | 1629182803 |
| Last Name Of The Provider | HENCEY |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 620 HARTSVILLE PIKE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GALLATIN |
| Zip Code Of The Provider | 370662523 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 170 |
| Number Of Services | 3208 |
| Number Of Medicare Beneficiaries | 1801 |
| Total Submitted Charge Amount | 528707.73 |
| Total Medicare Allowed Amount | 94006.11 |
| Total Medicare Payment Amount | 73595.02 |
| Total Medicare Standardized Payment Amount | 78535.78 |
| 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 | 170 |
| Number Of Medical Services | 3208 |
| Number Of Medicare Beneficiaries With Medical Services | 1801 |
| Total Medical Submitted Charge Amount | 528707.73 |
| Total Medical Medicare Allowed Amount | 94006.11 |
| Total Medical Medicare Payment Amount | 73595.02 |
| Total Medical Medicare Standardized Payment Amount | 78535.78 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 448 |
| Number Of Beneficiaries Age 65 to 74 | 659 |
| Number Of Beneficiaries Age 75 to 84 | 444 |
| Number Of Beneficiaries Age Greater 84 | 250 |
| Number Of Female Beneficiaries | 1141 |
| Number Of Male Beneficiaries | 660 |
| Number Of Non Hispanic White Beneficiaries | 1642 |
| Number Of Black or African American Beneficiaries | 128 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1171 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 630 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7418 |