| National Provider Identifier [NPI]: | 1023151313 |
| Last Name Of The Provider | WORDLAW-WATKINS |
| First Name Of The Provider | SANDRA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1720 PHOENIX BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | COLLEGE PARK |
| Zip Code Of The Provider | 303495594 |
| 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 | 37 |
| Number Of Services | 813 |
| Number Of Medicare Beneficiaries | 155 |
| Total Submitted Charge Amount | 89607 |
| Total Medicare Allowed Amount | 38169.61 |
| Total Medicare Payment Amount | 26915.82 |
| Total Medicare Standardized Payment Amount | 27292.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 80 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 6737 |
| Total Drug Medicare AllowedAmount | 2148.93 |
| Total Drug Medicare PaymentAmount | 2095.08 |
| Total Drug Medicare Standardized Payment Amount | 2095.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 733 |
| Number Of Medicare Beneficiaries With Medical Services | 155 |
| Total Medical Submitted Charge Amount | 82870 |
| Total Medical Medicare Allowed Amount | 36020.68 |
| Total Medical Medicare Payment Amount | 24820.74 |
| Total Medical Medicare Standardized Payment Amount | 25197.28 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 80 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 128 |
| Number Of Male Beneficiaries | 27 |
| Number Of Non Hispanic White Beneficiaries | 14 |
| Number Of Black or African American Beneficiaries | 130 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 136 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 19 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2938 |