| National Provider Identifier [NPI]: | 1750332250 |
| Last Name Of The Provider | HENDERSON |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 305 MEMORIAL MEDICAL PKWY |
| Street Address 2 Of The Provider | SUITE 301 |
| City Of The Provider | DAYTONA BEACH |
| Zip Code Of The Provider | 321175168 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 8792 |
| Number Of Medicare Beneficiaries | 2292 |
| Total Submitted Charge Amount | 1775622.21 |
| Total Medicare Allowed Amount | 984789.53 |
| Total Medicare Payment Amount | 743133.47 |
| Total Medicare Standardized Payment Amount | 747545.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 780 |
| Number Of Medicare Beneficiaries With Drug Services | 195 |
| Total Drug Submitted ChargeAmount | 117000 |
| Total Drug Medicare AllowedAmount | 41310.26 |
| Total Drug Medicare PaymentAmount | 32144.57 |
| Total Drug Medicare Standardized Payment Amount | 32144.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 100 |
| Number Of Medical Services | 8012 |
| Number Of Medicare Beneficiaries With Medical Services | 2292 |
| Total Medical Submitted Charge Amount | 1658622.21 |
| Total Medical Medicare Allowed Amount | 943479.27 |
| Total Medical Medicare Payment Amount | 710988.9 |
| Total Medical Medicare Standardized Payment Amount | 715400.56 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 120 |
| Number Of Beneficiaries Age 65 to 74 | 844 |
| Number Of Beneficiaries Age 75 to 84 | 875 |
| Number Of Beneficiaries Age Greater 84 | 453 |
| Number Of Female Beneficiaries | 1014 |
| Number Of Male Beneficiaries | 1278 |
| Number Of Non Hispanic White Beneficiaries | 2176 |
| Number Of Black or African American Beneficiaries | 59 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2102 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 190 |
| Percent Of With Atrial Fibrillation | 35 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5138 |