| National Provider Identifier [NPI]: | 1861572679 |
| Last Name Of The Provider | WATSON |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1301 N ROSE DR |
| Street Address 2 Of The Provider | DEPARTMENT OF EMERGENCY SERVICES |
| City Of The Provider | PLACENTIA |
| Zip Code Of The Provider | 928703802 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 696 |
| Number Of Medicare Beneficiaries | 527 |
| Total Submitted Charge Amount | 838351 |
| Total Medicare Allowed Amount | 107357.36 |
| Total Medicare Payment Amount | 82133.93 |
| Total Medicare Standardized Payment Amount | 74805.22 |
| 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 | 34 |
| Number Of Medical Services | 696 |
| Number Of Medicare Beneficiaries With Medical Services | 527 |
| Total Medical Submitted Charge Amount | 838351 |
| Total Medical Medicare Allowed Amount | 107357.36 |
| Total Medical Medicare Payment Amount | 82133.93 |
| Total Medical Medicare Standardized Payment Amount | 74805.22 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 119 |
| Number Of Beneficiaries Age 65 to 74 | 105 |
| Number Of Beneficiaries Age 75 to 84 | 127 |
| Number Of Beneficiaries Age Greater 84 | 176 |
| Number Of Female Beneficiaries | 291 |
| Number Of Male Beneficiaries | 236 |
| Number Of Non Hispanic White Beneficiaries | 344 |
| Number Of Black or African American Beneficiaries | 91 |
| 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 | 276 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 251 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 36 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 23 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.6033 |