National Provider Identifier [NPI]: |
1730295049 |
Last Name Of The Provider |
WATSON |
First Name Of The Provider |
RONALD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 E EL CAMINO REAL |
Street Address 2 Of The Provider |
|
City Of The Provider |
MOUNTAIN VIEW |
Zip Code Of The Provider |
940402833 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
1235 |
Number Of Medicare Beneficiaries |
455 |
Total Submitted Charge Amount |
231365 |
Total Medicare Allowed Amount |
111856.35 |
Total Medicare Payment Amount |
85422.18 |
Total Medicare Standardized Payment Amount |
74087.09 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
84 |
Number Of Medicare Beneficiaries With Drug Services |
59 |
Total Drug Submitted ChargeAmount |
3326 |
Total Drug Medicare AllowedAmount |
3162.42 |
Total Drug Medicare PaymentAmount |
3082.86 |
Total Drug Medicare Standardized Payment Amount |
3082.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
1151 |
Number Of Medicare Beneficiaries With Medical Services |
455 |
Total Medical Submitted Charge Amount |
228039 |
Total Medical Medicare Allowed Amount |
108693.93 |
Total Medical Medicare Payment Amount |
82339.32 |
Total Medical Medicare Standardized Payment Amount |
71004.23 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
196 |
Number Of Beneficiaries Age 75 to 84 |
153 |
Number Of Beneficiaries Age Greater 84 |
87 |
Number Of Female Beneficiaries |
211 |
Number Of Male Beneficiaries |
244 |
Number Of Non Hispanic White Beneficiaries |
359 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
56 |
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
400 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
55 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0761 |