| National Provider Identifier [NPI]: | 1235142894 |
| Last Name Of The Provider | WATSON |
| First Name Of The Provider | HENRY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5709 MARKET ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | OAKLAND |
| Zip Code Of The Provider | 946082811 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 5819 |
| Number Of Medicare Beneficiaries | 636 |
| Total Submitted Charge Amount | 907917.5 |
| Total Medicare Allowed Amount | 587832.36 |
| Total Medicare Payment Amount | 433748.64 |
| Total Medicare Standardized Payment Amount | 389234.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 28 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 694.5 |
| Total Drug Medicare AllowedAmount | 128.67 |
| Total Drug Medicare PaymentAmount | 116.53 |
| Total Drug Medicare Standardized Payment Amount | 116.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 5791 |
| Number Of Medicare Beneficiaries With Medical Services | 636 |
| Total Medical Submitted Charge Amount | 907223 |
| Total Medical Medicare Allowed Amount | 587703.69 |
| Total Medical Medicare Payment Amount | 433632.11 |
| Total Medical Medicare Standardized Payment Amount | 389117.95 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 257 |
| Number Of Beneficiaries Age 65 to 74 | 205 |
| Number Of Beneficiaries Age 75 to 84 | 111 |
| Number Of Beneficiaries Age Greater 84 | 63 |
| Number Of Female Beneficiaries | 353 |
| Number Of Male Beneficiaries | 283 |
| Number Of Non Hispanic White Beneficiaries | 96 |
| Number Of Black or African American Beneficiaries | 411 |
| Number Of AsianPacific Islander Beneficiaries | 63 |
| Number Of Hispanic Beneficiaries | 52 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 120 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 516 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7669 |