| National Provider Identifier [NPI]: | 1508816596 |
| Last Name Of The Provider | WATTERS |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 S SAN MATEO DR |
| Street Address 2 Of The Provider | SUITE 303 |
| City Of The Provider | SAN MATEO |
| Zip Code Of The Provider | 944013819 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nuclear Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 4 |
| Number Of Services | 1937 |
| Number Of Medicare Beneficiaries | 1910 |
| Total Submitted Charge Amount | 522230.3 |
| Total Medicare Allowed Amount | 174774.18 |
| Total Medicare Payment Amount | 130875.89 |
| Total Medicare Standardized Payment Amount | 116790.56 |
| 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 | 4 |
| Number Of Medical Services | 1937 |
| Number Of Medicare Beneficiaries With Medical Services | 1910 |
| Total Medical Submitted Charge Amount | 522230.3 |
| Total Medical Medicare Allowed Amount | 174774.18 |
| Total Medical Medicare Payment Amount | 130875.89 |
| Total Medical Medicare Standardized Payment Amount | 116790.56 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 155 |
| Number Of Beneficiaries Age 65 to 74 | 801 |
| Number Of Beneficiaries Age 75 to 84 | 739 |
| Number Of Beneficiaries Age Greater 84 | 215 |
| Number Of Female Beneficiaries | 794 |
| Number Of Male Beneficiaries | 1116 |
| Number Of Non Hispanic White Beneficiaries | 1066 |
| Number Of Black or African American Beneficiaries | 73 |
| Number Of AsianPacific Islander Beneficiaries | 493 |
| Number Of Hispanic Beneficiaries | 139 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | 128 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1605 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 305 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3113 |