| National Provider Identifier [NPI]: | 1700879848 |
| Last Name Of The Provider | HENDERSON |
| First Name Of The Provider | RANDALL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1314 N BRAZOS ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WHITNEY |
| Zip Code Of The Provider | 766922010 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 3133 |
| Number Of Medicare Beneficiaries | 861 |
| Total Submitted Charge Amount | 251014.8 |
| Total Medicare Allowed Amount | 175707.14 |
| Total Medicare Payment Amount | 123395.18 |
| Total Medicare Standardized Payment Amount | 130581.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 436 |
| Number Of Medicare Beneficiaries With Drug Services | 209 |
| Total Drug Submitted ChargeAmount | 12380.8 |
| Total Drug Medicare AllowedAmount | 4635.7 |
| Total Drug Medicare PaymentAmount | 4214.73 |
| Total Drug Medicare Standardized Payment Amount | 4214.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 2697 |
| Number Of Medicare Beneficiaries With Medical Services | 861 |
| Total Medical Submitted Charge Amount | 238634 |
| Total Medical Medicare Allowed Amount | 171071.44 |
| Total Medical Medicare Payment Amount | 119180.45 |
| Total Medical Medicare Standardized Payment Amount | 126367.08 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 150 |
| Number Of Beneficiaries Age 65 to 74 | 385 |
| Number Of Beneficiaries Age 75 to 84 | 237 |
| Number Of Beneficiaries Age Greater 84 | 89 |
| Number Of Female Beneficiaries | 458 |
| Number Of Male Beneficiaries | 403 |
| Number Of Non Hispanic White Beneficiaries | 806 |
| Number Of Black or African American Beneficiaries | 27 |
| 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 | 620 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 241 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0957 |