| National Provider Identifier [NPI]: | 1851463228 |
| Last Name Of The Provider | HENDERSON |
| First Name Of The Provider | REUBEN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3937 PATIENT CARE WAY |
| Street Address 2 Of The Provider | SUITE 107 |
| City Of The Provider | LANSING |
| Zip Code Of The Provider | 489114287 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 1786 |
| Number Of Medicare Beneficiaries | 238 |
| Total Submitted Charge Amount | 151723 |
| Total Medicare Allowed Amount | 102594.74 |
| Total Medicare Payment Amount | 70296.82 |
| Total Medicare Standardized Payment Amount | 73061.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 103 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 1290 |
| Total Drug Medicare AllowedAmount | 128.54 |
| Total Drug Medicare PaymentAmount | 90.57 |
| Total Drug Medicare Standardized Payment Amount | 90.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 1683 |
| Number Of Medicare Beneficiaries With Medical Services | 238 |
| Total Medical Submitted Charge Amount | 150433 |
| Total Medical Medicare Allowed Amount | 102466.2 |
| Total Medical Medicare Payment Amount | 70206.25 |
| Total Medical Medicare Standardized Payment Amount | 72971.32 |
| Average Age Of Beneficiaries | 55 |
| Number Of Beneficiaries Age Less65 | 176 |
| Number Of Beneficiaries Age 65 to 74 | 46 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 140 |
| Number Of Male Beneficiaries | 98 |
| Number Of Non Hispanic White Beneficiaries | 174 |
| Number Of Black or African American Beneficiaries | 42 |
| 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 | 132 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 106 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 27 |
| Percent Of With Hypertension | 39 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1317 |