| National Provider Identifier [NPI]: | 1275601346 |
| Last Name Of The Provider | WATSON |
| First Name Of The Provider | ANGELA |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1750 MADISON AVE |
| Street Address 2 Of The Provider | STE 401 |
| City Of The Provider | MEMPHIS |
| Zip Code Of The Provider | 38104 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 4800 |
| Number Of Medicare Beneficiaries | 911 |
| Total Submitted Charge Amount | 502078 |
| Total Medicare Allowed Amount | 298621.32 |
| Total Medicare Payment Amount | 220669.87 |
| Total Medicare Standardized Payment Amount | 236812.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 118 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 2769 |
| Total Drug Medicare AllowedAmount | 964.45 |
| Total Drug Medicare PaymentAmount | 891.95 |
| Total Drug Medicare Standardized Payment Amount | 891.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 4682 |
| Number Of Medicare Beneficiaries With Medical Services | 911 |
| Total Medical Submitted Charge Amount | 499309 |
| Total Medical Medicare Allowed Amount | 297656.87 |
| Total Medical Medicare Payment Amount | 219777.92 |
| Total Medical Medicare Standardized Payment Amount | 235920.77 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 162 |
| Number Of Beneficiaries Age 65 to 74 | 279 |
| Number Of Beneficiaries Age 75 to 84 | 233 |
| Number Of Beneficiaries Age Greater 84 | 237 |
| Number Of Female Beneficiaries | 610 |
| Number Of Male Beneficiaries | 301 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 677 |
| 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 | 277 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 634 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 63 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 26 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.5065 |