National Provider Identifier [NPI]: |
1104096551 |
Last Name Of The Provider |
WATT |
First Name Of The Provider |
CLIFTON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 W CARSON ST |
Street Address 2 Of The Provider |
BOX 459 |
City Of The Provider |
TORRANCE |
Zip Code Of The Provider |
905022004 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
715 |
Number Of Medicare Beneficiaries |
318 |
Total Submitted Charge Amount |
198946.55 |
Total Medicare Allowed Amount |
87880.04 |
Total Medicare Payment Amount |
68547.22 |
Total Medicare Standardized Payment Amount |
60324.3 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
92 |
Number Of Medicare Beneficiaries With Drug Services |
23 |
Total Drug Submitted ChargeAmount |
8579 |
Total Drug Medicare AllowedAmount |
4854.99 |
Total Drug Medicare PaymentAmount |
3806.23 |
Total Drug Medicare Standardized Payment Amount |
3806.23 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
38 |
Number Of Medical Services |
623 |
Number Of Medicare Beneficiaries With Medical Services |
318 |
Total Medical Submitted Charge Amount |
190367.55 |
Total Medical Medicare Allowed Amount |
83025.05 |
Total Medical Medicare Payment Amount |
64740.99 |
Total Medical Medicare Standardized Payment Amount |
56518.07 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
111 |
Number Of Beneficiaries Age 75 to 84 |
100 |
Number Of Beneficiaries Age Greater 84 |
63 |
Number Of Female Beneficiaries |
153 |
Number Of Male Beneficiaries |
165 |
Number Of Non Hispanic White Beneficiaries |
178 |
Number Of Black or African American Beneficiaries |
66 |
Number Of AsianPacific Islander Beneficiaries |
41 |
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
198 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
120 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6752 |