| National Provider Identifier [NPI]: | 1801884234 |
| Last Name Of The Provider | HENSLEY |
| First Name Of The Provider | SAMUEL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1405 N STATE ST |
| Street Address 2 Of The Provider | STE 300 |
| City Of The Provider | JACKSON |
| Zip Code Of The Provider | 392021642 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 6 |
| Number Of Services | 12007 |
| Number Of Medicare Beneficiaries | 2652 |
| Total Submitted Charge Amount | 1454644 |
| Total Medicare Allowed Amount | 394302.72 |
| Total Medicare Payment Amount | 280342.4 |
| Total Medicare Standardized Payment Amount | 203158.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 6 |
| Number Of Medical Services | 12007 |
| Number Of Medicare Beneficiaries With Medical Services | 2652 |
| Total Medical Submitted Charge Amount | 1454644 |
| Total Medical Medicare Allowed Amount | 394302.72 |
| Total Medical Medicare Payment Amount | 280342.4 |
| Total Medical Medicare Standardized Payment Amount | 203158.38 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 426 |
| Number Of Beneficiaries Age 65 to 74 | 1531 |
| Number Of Beneficiaries Age 75 to 84 | 628 |
| Number Of Beneficiaries Age Greater 84 | 67 |
| Number Of Female Beneficiaries | 1476 |
| Number Of Male Beneficiaries | 1176 |
| Number Of Non Hispanic White Beneficiaries | 1867 |
| Number Of Black or African American Beneficiaries | 750 |
| 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 | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2205 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 447 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.846 |