| National Provider Identifier [NPI]: | 1811925183 |
| Last Name Of The Provider | HENRY |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2319 E WASHINGTON BLVD |
| Street Address 2 Of The Provider | SUITE 2 |
| City Of The Provider | PASADENA |
| Zip Code Of The Provider | 911041945 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 157 |
| Number Of Services | 8735 |
| Number Of Medicare Beneficiaries | 365 |
| Total Submitted Charge Amount | 511081 |
| Total Medicare Allowed Amount | 376593.36 |
| Total Medicare Payment Amount | 290449.21 |
| Total Medicare Standardized Payment Amount | 329584.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 32 |
| Number Of Drug Services | 2752 |
| Number Of Medicare Beneficiaries With Drug Services | 268 |
| Total Drug Submitted ChargeAmount | 76347 |
| Total Drug Medicare AllowedAmount | 23118.14 |
| Total Drug Medicare PaymentAmount | 21437.04 |
| Total Drug Medicare Standardized Payment Amount | 21437.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 125 |
| Number Of Medical Services | 5983 |
| Number Of Medicare Beneficiaries With Medical Services | 365 |
| Total Medical Submitted Charge Amount | 434734 |
| Total Medical Medicare Allowed Amount | 353475.22 |
| Total Medical Medicare Payment Amount | 269012.17 |
| Total Medical Medicare Standardized Payment Amount | 308147.29 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 209 |
| Number Of Beneficiaries Age 75 to 84 | 83 |
| Number Of Beneficiaries Age Greater 84 | 57 |
| Number Of Female Beneficiaries | 184 |
| Number Of Male Beneficiaries | 181 |
| Number Of Non Hispanic White Beneficiaries | 326 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 354 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9031 |