| National Provider Identifier [NPI]: | 1336236447 |
| Last Name Of The Provider | WATSON |
| First Name Of The Provider | JEFFRY |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4110 BRIARGATE PKWY |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | COLORADO SPRINGS |
| Zip Code Of The Provider | 809207835 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hand Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 126 |
| Number Of Services | 1697 |
| Number Of Medicare Beneficiaries | 267 |
| Total Submitted Charge Amount | 533205.11 |
| Total Medicare Allowed Amount | 147836.41 |
| Total Medicare Payment Amount | 111801.78 |
| Total Medicare Standardized Payment Amount | 110573.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 702 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 38958 |
| Total Drug Medicare AllowedAmount | 21407.35 |
| Total Drug Medicare PaymentAmount | 14742.64 |
| Total Drug Medicare Standardized Payment Amount | 14742.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 122 |
| Number Of Medical Services | 995 |
| Number Of Medicare Beneficiaries With Medical Services | 267 |
| Total Medical Submitted Charge Amount | 494247.11 |
| Total Medical Medicare Allowed Amount | 126429.06 |
| Total Medical Medicare Payment Amount | 97059.14 |
| Total Medical Medicare Standardized Payment Amount | 95831.05 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 117 |
| Number Of Beneficiaries Age 75 to 84 | 86 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 154 |
| Number Of Male Beneficiaries | 113 |
| Number Of Non Hispanic White Beneficiaries | 230 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 231 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1005 |