| National Provider Identifier [NPI]: | 1457456808 |
| Last Name Of The Provider | HENRY |
| First Name Of The Provider | ROBERT |
| 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 | 10001 LILE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | LITTLE ROCK |
| Zip Code Of The Provider | 722056217 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 171 |
| Number Of Services | 5732 |
| Number Of Medicare Beneficiaries | 267 |
| Total Submitted Charge Amount | 325703.9 |
| Total Medicare Allowed Amount | 139069.68 |
| Total Medicare Payment Amount | 109868.04 |
| Total Medicare Standardized Payment Amount | 117261.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 1310 |
| Number Of Medicare Beneficiaries With Drug Services | 124 |
| Total Drug Submitted ChargeAmount | 17052.49 |
| Total Drug Medicare AllowedAmount | 8493.91 |
| Total Drug Medicare PaymentAmount | 8043.81 |
| Total Drug Medicare Standardized Payment Amount | 8043.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 159 |
| Number Of Medical Services | 4422 |
| Number Of Medicare Beneficiaries With Medical Services | 267 |
| Total Medical Submitted Charge Amount | 308651.41 |
| Total Medical Medicare Allowed Amount | 130575.77 |
| Total Medical Medicare Payment Amount | 101824.23 |
| Total Medical Medicare Standardized Payment Amount | 109218 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 122 |
| Number Of Beneficiaries Age 75 to 84 | 95 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 118 |
| Number Of Male Beneficiaries | 149 |
| Number Of Non Hispanic White Beneficiaries | 248 |
| 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 | 254 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9963 |