| National Provider Identifier [NPI]: | 1972535615 |
| Last Name Of The Provider | WATERS |
| First Name Of The Provider | DONALD |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 120 E CARTER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | BLACKSHEAR |
| Zip Code Of The Provider | 315161561 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 173 |
| Number Of Services | 7535 |
| Number Of Medicare Beneficiaries | 873 |
| Total Submitted Charge Amount | 477457.02 |
| Total Medicare Allowed Amount | 299897.98 |
| Total Medicare Payment Amount | 205999.99 |
| Total Medicare Standardized Payment Amount | 220868.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 19 |
| Number Of Drug Services | 1607 |
| Number Of Medicare Beneficiaries With Drug Services | 207 |
| Total Drug Submitted ChargeAmount | 26045.02 |
| Total Drug Medicare AllowedAmount | 16088.68 |
| Total Drug Medicare PaymentAmount | 12620.55 |
| Total Drug Medicare Standardized Payment Amount | 12620.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 154 |
| Number Of Medical Services | 5928 |
| Number Of Medicare Beneficiaries With Medical Services | 873 |
| Total Medical Submitted Charge Amount | 451412 |
| Total Medical Medicare Allowed Amount | 283809.3 |
| Total Medical Medicare Payment Amount | 193379.44 |
| Total Medical Medicare Standardized Payment Amount | 208247.48 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 143 |
| Number Of Beneficiaries Age 65 to 74 | 373 |
| Number Of Beneficiaries Age 75 to 84 | 246 |
| Number Of Beneficiaries Age Greater 84 | 111 |
| Number Of Female Beneficiaries | 486 |
| Number Of Male Beneficiaries | 387 |
| Number Of Non Hispanic White Beneficiaries | 811 |
| 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 | 641 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 232 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1276 |