National Provider Identifier [NPI]: |
1649373739 |
Last Name Of The Provider |
WATTS |
First Name Of The Provider |
ELI |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2001 CHARLOTTE AVE |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
NASHVILLE |
Zip Code Of The Provider |
372032032 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
1584 |
Number Of Medicare Beneficiaries |
501 |
Total Submitted Charge Amount |
391479.45 |
Total Medicare Allowed Amount |
158010.06 |
Total Medicare Payment Amount |
122056.46 |
Total Medicare Standardized Payment Amount |
124065 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
1584 |
Number Of Medicare Beneficiaries With Medical Services |
501 |
Total Medical Submitted Charge Amount |
391479.45 |
Total Medical Medicare Allowed Amount |
158010.06 |
Total Medical Medicare Payment Amount |
122056.46 |
Total Medical Medicare Standardized Payment Amount |
124065 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
101 |
Number Of Beneficiaries Age 65 to 74 |
128 |
Number Of Beneficiaries Age 75 to 84 |
155 |
Number Of Beneficiaries Age Greater 84 |
117 |
Number Of Female Beneficiaries |
305 |
Number Of Male Beneficiaries |
196 |
Number Of Non Hispanic White Beneficiaries |
463 |
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 |
362 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
139 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.2286 |