| National Provider Identifier [NPI]: | 1538111240 |
| Last Name Of The Provider | HENLEY |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9480 BRIAR VILLAGE PT |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | COLORADO SPRINGS |
| Zip Code Of The Provider | 809207922 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 1625 |
| Number Of Medicare Beneficiaries | 226 |
| Total Submitted Charge Amount | 130466.81 |
| Total Medicare Allowed Amount | 69713.62 |
| Total Medicare Payment Amount | 50149.53 |
| Total Medicare Standardized Payment Amount | 51387.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 485 |
| Number Of Medicare Beneficiaries With Drug Services | 131 |
| Total Drug Submitted ChargeAmount | 20303.8 |
| Total Drug Medicare AllowedAmount | 11043.73 |
| Total Drug Medicare PaymentAmount | 10266.24 |
| Total Drug Medicare Standardized Payment Amount | 10266.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 1140 |
| Number Of Medicare Beneficiaries With Medical Services | 226 |
| Total Medical Submitted Charge Amount | 110163.01 |
| Total Medical Medicare Allowed Amount | 58669.89 |
| Total Medical Medicare Payment Amount | 39883.29 |
| Total Medical Medicare Standardized Payment Amount | 41121.23 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 140 |
| Number Of Beneficiaries Age 75 to 84 | 55 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 122 |
| Number Of Male Beneficiaries | 104 |
| Number Of Non Hispanic White Beneficiaries | 207 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 7 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 12 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7878 |