| National Provider Identifier [NPI]: | 1114930468 |
| Last Name Of The Provider | HEATH |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 50 PARKWAY LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | PETAL |
| Zip Code Of The Provider | 394653035 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 78 |
| Number Of Services | 4573 |
| Number Of Medicare Beneficiaries | 431 |
| Total Submitted Charge Amount | 351907 |
| Total Medicare Allowed Amount | 207196.88 |
| Total Medicare Payment Amount | 149435.7 |
| Total Medicare Standardized Payment Amount | 162824.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 348 |
| Number Of Medicare Beneficiaries With Drug Services | 238 |
| Total Drug Submitted ChargeAmount | 18944 |
| Total Drug Medicare AllowedAmount | 6217.78 |
| Total Drug Medicare PaymentAmount | 5851.66 |
| Total Drug Medicare Standardized Payment Amount | 5851.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 4225 |
| Number Of Medicare Beneficiaries With Medical Services | 431 |
| Total Medical Submitted Charge Amount | 332963 |
| Total Medical Medicare Allowed Amount | 200979.1 |
| Total Medical Medicare Payment Amount | 143584.04 |
| Total Medical Medicare Standardized Payment Amount | 156973.17 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 183 |
| Number Of Beneficiaries Age 75 to 84 | 117 |
| Number Of Beneficiaries Age Greater 84 | 67 |
| Number Of Female Beneficiaries | 262 |
| Number Of Male Beneficiaries | 169 |
| Number Of Non Hispanic White Beneficiaries | 391 |
| Number Of Black or African American Beneficiaries | |
| 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 | 296 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 135 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1692 |