| National Provider Identifier [NPI]: | 1306827639 |
| Last Name Of The Provider | HENDRICKS |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 840 PINE STREET |
| Street Address 2 Of The Provider | SUITE 780 |
| City Of The Provider | MACON |
| Zip Code Of The Provider | 31201 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 6211 |
| Number Of Medicare Beneficiaries | 1555 |
| Total Submitted Charge Amount | 1020106.2 |
| Total Medicare Allowed Amount | 426946.44 |
| Total Medicare Payment Amount | 322520.94 |
| Total Medicare Standardized Payment Amount | 342457.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 136 |
| Number Of Medicare Beneficiaries With Drug Services | 120 |
| Total Drug Submitted ChargeAmount | 9110 |
| Total Drug Medicare AllowedAmount | 4752.71 |
| Total Drug Medicare PaymentAmount | 4634.16 |
| Total Drug Medicare Standardized Payment Amount | 4634.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 6075 |
| Number Of Medicare Beneficiaries With Medical Services | 1555 |
| Total Medical Submitted Charge Amount | 1010996.2 |
| Total Medical Medicare Allowed Amount | 422193.73 |
| Total Medical Medicare Payment Amount | 317886.78 |
| Total Medical Medicare Standardized Payment Amount | 337823.46 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 309 |
| Number Of Beneficiaries Age 65 to 74 | 639 |
| Number Of Beneficiaries Age 75 to 84 | 482 |
| Number Of Beneficiaries Age Greater 84 | 125 |
| Number Of Female Beneficiaries | 830 |
| Number Of Male Beneficiaries | 725 |
| Number Of Non Hispanic White Beneficiaries | 1288 |
| Number Of Black or African American Beneficiaries | 245 |
| 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 | 1283 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 272 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.8021 |