National Provider Identifier [NPI]: |
1235479619 |
Last Name Of The Provider |
WATSON |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
13737 NOEL ROAD |
Street Address 2 Of The Provider |
SUITE 1400 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752402004 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
69 |
Number Of Services |
379 |
Number Of Medicare Beneficiaries |
367 |
Total Submitted Charge Amount |
729479.55 |
Total Medicare Allowed Amount |
75625.27 |
Total Medicare Payment Amount |
59056.34 |
Total Medicare Standardized Payment Amount |
60726.64 |
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 |
69 |
Number Of Medical Services |
379 |
Number Of Medicare Beneficiaries With Medical Services |
367 |
Total Medical Submitted Charge Amount |
729479.55 |
Total Medical Medicare Allowed Amount |
75625.27 |
Total Medical Medicare Payment Amount |
59056.34 |
Total Medical Medicare Standardized Payment Amount |
60726.64 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
67 |
Number Of Beneficiaries Age 65 to 74 |
166 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
197 |
Number Of Male Beneficiaries |
170 |
Number Of Non Hispanic White Beneficiaries |
339 |
Number Of Black or African American Beneficiaries |
11 |
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
292 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
75 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.654 |