| National Provider Identifier [NPI]: | 1689962920 |
| Last Name Of The Provider | WATT |
| First Name Of The Provider | TENICA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | CRNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8124 VETERANS HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | MILLERSVILLE |
| Zip Code Of The Provider | 211081412 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 605 |
| Number Of Medicare Beneficiaries | 290 |
| Total Submitted Charge Amount | 21774.66 |
| Total Medicare Allowed Amount | 20596.47 |
| Total Medicare Payment Amount | 16576.15 |
| Total Medicare Standardized Payment Amount | 18661.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 239 |
| Number Of Medicare Beneficiaries With Drug Services | 217 |
| Total Drug Submitted ChargeAmount | 7705.66 |
| Total Drug Medicare AllowedAmount | 7527.82 |
| Total Drug Medicare PaymentAmount | 7242.01 |
| Total Drug Medicare Standardized Payment Amount | 7242.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 366 |
| Number Of Medicare Beneficiaries With Medical Services | 287 |
| Total Medical Submitted Charge Amount | 14069 |
| Total Medical Medicare Allowed Amount | 13068.65 |
| Total Medical Medicare Payment Amount | 9334.14 |
| Total Medical Medicare Standardized Payment Amount | 11419.46 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 176 |
| Number Of Beneficiaries Age 75 to 84 | 76 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 173 |
| Number Of Male Beneficiaries | 117 |
| Number Of Non Hispanic White Beneficiaries | 261 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 274 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7817 |