| National Provider Identifier [NPI]: | 1043200579 |
| Last Name Of The Provider | WATERS |
| First Name Of The Provider | BRENDAN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2300 OPITZ BLVD |
| Street Address 2 Of The Provider | DEPT OF RADIOLOGY |
| City Of The Provider | WOODBRIDGE |
| Zip Code Of The Provider | 22191 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 182 |
| Number Of Services | 7229 |
| Number Of Medicare Beneficiaries | 4379 |
| Total Submitted Charge Amount | 1264436.99 |
| Total Medicare Allowed Amount | 306517.37 |
| Total Medicare Payment Amount | 248467.77 |
| Total Medicare Standardized Payment Amount | 232832.46 |
| 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 | 182 |
| Number Of Medical Services | 7229 |
| Number Of Medicare Beneficiaries With Medical Services | 4379 |
| Total Medical Submitted Charge Amount | 1264436.99 |
| Total Medical Medicare Allowed Amount | 306517.37 |
| Total Medical Medicare Payment Amount | 248467.77 |
| Total Medical Medicare Standardized Payment Amount | 232832.46 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 467 |
| Number Of Beneficiaries Age 65 to 74 | 1789 |
| Number Of Beneficiaries Age 75 to 84 | 1311 |
| Number Of Beneficiaries Age Greater 84 | 812 |
| Number Of Female Beneficiaries | 2907 |
| Number Of Male Beneficiaries | 1472 |
| Number Of Non Hispanic White Beneficiaries | 3002 |
| Number Of Black or African American Beneficiaries | 842 |
| Number Of AsianPacific Islander Beneficiaries | 216 |
| Number Of Hispanic Beneficiaries | 213 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3643 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 736 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4484 |