| National Provider Identifier [NPI]: | 1306045877 |
| Last Name Of The Provider | WATERS |
| First Name Of The Provider | JUSTIN |
| 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 | 1304 FAWCETT AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | TACOMA |
| Zip Code Of The Provider | 984021911 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 126 |
| Number Of Services | 11037 |
| Number Of Medicare Beneficiaries | 3145 |
| Total Submitted Charge Amount | 1635555.5 |
| Total Medicare Allowed Amount | 375328 |
| Total Medicare Payment Amount | 280732.52 |
| Total Medicare Standardized Payment Amount | 287966.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 6199 |
| Number Of Medicare Beneficiaries With Drug Services | 199 |
| Total Drug Submitted ChargeAmount | 30380 |
| Total Drug Medicare AllowedAmount | 6017.37 |
| Total Drug Medicare PaymentAmount | 4681.05 |
| Total Drug Medicare Standardized Payment Amount | 4681.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 123 |
| Number Of Medical Services | 4838 |
| Number Of Medicare Beneficiaries With Medical Services | 3144 |
| Total Medical Submitted Charge Amount | 1605175.5 |
| Total Medical Medicare Allowed Amount | 369310.63 |
| Total Medical Medicare Payment Amount | 276051.47 |
| Total Medical Medicare Standardized Payment Amount | 283285.94 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 611 |
| Number Of Beneficiaries Age 65 to 74 | 1074 |
| Number Of Beneficiaries Age 75 to 84 | 901 |
| Number Of Beneficiaries Age Greater 84 | 559 |
| Number Of Female Beneficiaries | 1816 |
| Number Of Male Beneficiaries | 1329 |
| Number Of Non Hispanic White Beneficiaries | 2560 |
| Number Of Black or African American Beneficiaries | 191 |
| Number Of AsianPacific Islander Beneficiaries | 211 |
| Number Of Hispanic Beneficiaries | 79 |
| Number Of American Indian Alaska Native Beneficiaries | 53 |
| Number Of Beneficiaries With Race Not Else where Classified | 51 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2217 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 928 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 1.7117 |