| National Provider Identifier [NPI]: | 1619995628 |
| Last Name Of The Provider | HENRY |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1611 NW 12TH AVE |
| Street Address 2 Of The Provider | BOX 016960 (M851) |
| City Of The Provider | MIAMI |
| Zip Code Of The Provider | 331361005 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 125 |
| Number Of Services | 5723 |
| Number Of Medicare Beneficiaries | 2538 |
| Total Submitted Charge Amount | 404822.09 |
| Total Medicare Allowed Amount | 127377.92 |
| Total Medicare Payment Amount | 95762.54 |
| Total Medicare Standardized Payment Amount | 97603.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2555 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 1659.75 |
| Total Drug Medicare AllowedAmount | 940.7 |
| Total Drug Medicare PaymentAmount | 737.5 |
| Total Drug Medicare Standardized Payment Amount | 737.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 123 |
| Number Of Medical Services | 3168 |
| Number Of Medicare Beneficiaries With Medical Services | 2536 |
| Total Medical Submitted Charge Amount | 403162.34 |
| Total Medical Medicare Allowed Amount | 126437.22 |
| Total Medical Medicare Payment Amount | 95025.04 |
| Total Medical Medicare Standardized Payment Amount | 96865.96 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 452 |
| Number Of Beneficiaries Age 65 to 74 | 842 |
| Number Of Beneficiaries Age 75 to 84 | 772 |
| Number Of Beneficiaries Age Greater 84 | 472 |
| Number Of Female Beneficiaries | 1467 |
| Number Of Male Beneficiaries | 1071 |
| Number Of Non Hispanic White Beneficiaries | 1828 |
| Number Of Black or African American Beneficiaries | 259 |
| Number Of AsianPacific Islander Beneficiaries | 50 |
| Number Of Hispanic Beneficiaries | 357 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1860 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 678 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 2.0499 |