| National Provider Identifier [NPI]: | 1295946564 |
| Last Name Of The Provider | HENDERSON |
| First Name Of The Provider | BENJAMIN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4801 AMBASSADOR CAFFERY PKWY |
| Street Address 2 Of The Provider | DEPT OF RADIOLOGY |
| City Of The Provider | LAFAYETTE |
| Zip Code Of The Provider | 705086917 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 263 |
| Number Of Services | 6459 |
| Number Of Medicare Beneficiaries | 3620 |
| Total Submitted Charge Amount | 928037 |
| Total Medicare Allowed Amount | 211167.84 |
| Total Medicare Payment Amount | 163416.14 |
| Total Medicare Standardized Payment Amount | 170869.44 |
| 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 | 263 |
| Number Of Medical Services | 6459 |
| Number Of Medicare Beneficiaries With Medical Services | 3620 |
| Total Medical Submitted Charge Amount | 928037 |
| Total Medical Medicare Allowed Amount | 211167.84 |
| Total Medical Medicare Payment Amount | 163416.14 |
| Total Medical Medicare Standardized Payment Amount | 170869.44 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 764 |
| Number Of Beneficiaries Age 65 to 74 | 1302 |
| Number Of Beneficiaries Age 75 to 84 | 1033 |
| Number Of Beneficiaries Age Greater 84 | 521 |
| Number Of Female Beneficiaries | 1992 |
| Number Of Male Beneficiaries | 1628 |
| Number Of Non Hispanic White Beneficiaries | 2668 |
| Number Of Black or African American Beneficiaries | 804 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 97 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2288 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1332 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.8544 |