| National Provider Identifier [NPI]: | 1366523110 |
| Last Name Of The Provider | HENDERSON |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2308 HOMER CLAYTON DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | GUNTERSVILLE |
| Zip Code Of The Provider | 359762206 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 107 |
| Number Of Services | 6108 |
| Number Of Medicare Beneficiaries | 656 |
| Total Submitted Charge Amount | 371920.36 |
| Total Medicare Allowed Amount | 362763 |
| Total Medicare Payment Amount | 253134.53 |
| Total Medicare Standardized Payment Amount | 275231.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 951 |
| Number Of Medicare Beneficiaries With Drug Services | 345 |
| Total Drug Submitted ChargeAmount | 14375.02 |
| Total Drug Medicare AllowedAmount | 13417.17 |
| Total Drug Medicare PaymentAmount | 12549.18 |
| Total Drug Medicare Standardized Payment Amount | 12549.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 5157 |
| Number Of Medicare Beneficiaries With Medical Services | 656 |
| Total Medical Submitted Charge Amount | 357545.34 |
| Total Medical Medicare Allowed Amount | 349345.83 |
| Total Medical Medicare Payment Amount | 240585.35 |
| Total Medical Medicare Standardized Payment Amount | 262682.3 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 129 |
| Number Of Beneficiaries Age 65 to 74 | 235 |
| Number Of Beneficiaries Age 75 to 84 | 203 |
| Number Of Beneficiaries Age Greater 84 | 89 |
| Number Of Female Beneficiaries | 388 |
| Number Of Male Beneficiaries | 268 |
| Number Of Non Hispanic White Beneficiaries | 632 |
| 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 | 430 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 226 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2128 |