| National Provider Identifier [NPI]: | 1720173057 |
| Last Name Of The Provider | HENRY |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1010 NORTH BANCROFT PARKWAY |
| Street Address 2 Of The Provider | SUITE 12 |
| City Of The Provider | WILMINGTON |
| Zip Code Of The Provider | 198052668 |
| State Code Of The Provider | DE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 3838 |
| Number Of Medicare Beneficiaries | 756 |
| Total Submitted Charge Amount | 293729 |
| Total Medicare Allowed Amount | 196802.88 |
| Total Medicare Payment Amount | 139963.33 |
| Total Medicare Standardized Payment Amount | 139681.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 79 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 510 |
| Total Drug Medicare AllowedAmount | 122.53 |
| Total Drug Medicare PaymentAmount | 87.2 |
| Total Drug Medicare Standardized Payment Amount | 87.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 3759 |
| Number Of Medicare Beneficiaries With Medical Services | 756 |
| Total Medical Submitted Charge Amount | 293219 |
| Total Medical Medicare Allowed Amount | 196680.35 |
| Total Medical Medicare Payment Amount | 139876.13 |
| Total Medical Medicare Standardized Payment Amount | 139594.19 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 126 |
| Number Of Beneficiaries Age 65 to 74 | 284 |
| Number Of Beneficiaries Age 75 to 84 | 228 |
| Number Of Beneficiaries Age Greater 84 | 118 |
| Number Of Female Beneficiaries | 477 |
| Number Of Male Beneficiaries | 279 |
| Number Of Non Hispanic White Beneficiaries | 444 |
| Number Of Black or African American Beneficiaries | 270 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 551 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 205 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4794 |