| National Provider Identifier [NPI]: | 1023101953 |
| Last Name Of The Provider | WATKINS |
| First Name Of The Provider | MARILYN |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | CFNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5717 SO ANTHONY |
| Street Address 2 Of The Provider | SU 500 |
| City Of The Provider | FORT WAYNE |
| Zip Code Of The Provider | 46806 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 4 |
| Number Of Services | 305 |
| Number Of Medicare Beneficiaries | 124 |
| Total Submitted Charge Amount | 106863 |
| Total Medicare Allowed Amount | 38543.39 |
| Total Medicare Payment Amount | 28400.48 |
| Total Medicare Standardized Payment Amount | 36456.98 |
| 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 | 4 |
| Number Of Medical Services | 305 |
| Number Of Medicare Beneficiaries With Medical Services | 124 |
| Total Medical Submitted Charge Amount | 106863 |
| Total Medical Medicare Allowed Amount | 38543.39 |
| Total Medical Medicare Payment Amount | 28400.48 |
| Total Medical Medicare Standardized Payment Amount | 36456.98 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 29 |
| Number Of Beneficiaries Age 75 to 84 | 19 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 59 |
| Number Of Male Beneficiaries | 65 |
| Number Of Non Hispanic White Beneficiaries | 87 |
| 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 | 57 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 63 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 75 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 8.9594 |