| National Provider Identifier [NPI]: | 1548271489 |
| Last Name Of The Provider | HENDRICKSON |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 109 DANIEL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | DANVILLE |
| Zip Code Of The Provider | 404222527 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 92 |
| Number Of Services | 15728 |
| Number Of Medicare Beneficiaries | 1643 |
| Total Submitted Charge Amount | 833050.29 |
| Total Medicare Allowed Amount | 478851.14 |
| Total Medicare Payment Amount | 330434.94 |
| Total Medicare Standardized Payment Amount | 363975.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 781 |
| Number Of Medicare Beneficiaries With Drug Services | 485 |
| Total Drug Submitted ChargeAmount | 23813 |
| Total Drug Medicare AllowedAmount | 11526.34 |
| Total Drug Medicare PaymentAmount | 10953.21 |
| Total Drug Medicare Standardized Payment Amount | 10953.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 14947 |
| Number Of Medicare Beneficiaries With Medical Services | 1643 |
| Total Medical Submitted Charge Amount | 809237.29 |
| Total Medical Medicare Allowed Amount | 467324.8 |
| Total Medical Medicare Payment Amount | 319481.73 |
| Total Medical Medicare Standardized Payment Amount | 353022.15 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 375 |
| Number Of Beneficiaries Age 65 to 74 | 608 |
| Number Of Beneficiaries Age 75 to 84 | 444 |
| Number Of Beneficiaries Age Greater 84 | 216 |
| Number Of Female Beneficiaries | 984 |
| Number Of Male Beneficiaries | 659 |
| Number Of Non Hispanic White Beneficiaries | 1539 |
| Number Of Black or African American Beneficiaries | 92 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1128 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 515 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2086 |