| National Provider Identifier [NPI]: | 1487654877 |
| Last Name Of The Provider | HENRY |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1320 BROADCASTING RD |
| Street Address 2 Of The Provider | STE 200 |
| City Of The Provider | WYOMISSING |
| Zip Code Of The Provider | 196103222 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 106 |
| Number Of Services | 3790 |
| Number Of Medicare Beneficiaries | 790 |
| Total Submitted Charge Amount | 1545733 |
| Total Medicare Allowed Amount | 408894.07 |
| Total Medicare Payment Amount | 309693.24 |
| Total Medicare Standardized Payment Amount | 319136.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 262 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 158400 |
| Total Drug Medicare AllowedAmount | 54958.32 |
| Total Drug Medicare PaymentAmount | 43043.42 |
| Total Drug Medicare Standardized Payment Amount | 43043.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 104 |
| Number Of Medical Services | 3528 |
| Number Of Medicare Beneficiaries With Medical Services | 790 |
| Total Medical Submitted Charge Amount | 1387333 |
| Total Medical Medicare Allowed Amount | 353935.75 |
| Total Medical Medicare Payment Amount | 266649.82 |
| Total Medical Medicare Standardized Payment Amount | 276093.41 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 280 |
| Number Of Beneficiaries Age 75 to 84 | 299 |
| Number Of Beneficiaries Age Greater 84 | 152 |
| Number Of Female Beneficiaries | 192 |
| Number Of Male Beneficiaries | 598 |
| Number Of Non Hispanic White Beneficiaries | 737 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 718 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 72 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 33 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5272 |