National Provider Identifier [NPI]: |
1558303537 |
Last Name Of The Provider |
WATSON |
First Name Of The Provider |
PATRICIA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
115 W SILVER ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WESTFIELD |
Zip Code Of The Provider |
010853628 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
236 |
Number Of Medicare Beneficiaries |
206 |
Total Submitted Charge Amount |
159400 |
Total Medicare Allowed Amount |
18422.4 |
Total Medicare Payment Amount |
13711.81 |
Total Medicare Standardized Payment Amount |
16217.61 |
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 |
23 |
Number Of Medical Services |
236 |
Number Of Medicare Beneficiaries With Medical Services |
206 |
Total Medical Submitted Charge Amount |
159400 |
Total Medical Medicare Allowed Amount |
18422.4 |
Total Medical Medicare Payment Amount |
13711.81 |
Total Medical Medicare Standardized Payment Amount |
16217.61 |
Average Age Of Beneficiaries |
56 |
Number Of Beneficiaries Age Less65 |
130 |
Number Of Beneficiaries Age 65 to 74 |
43 |
Number Of Beneficiaries Age 75 to 84 |
20 |
Number Of Beneficiaries Age Greater 84 |
13 |
Number Of Female Beneficiaries |
120 |
Number Of Male Beneficiaries |
86 |
Number Of Non Hispanic White Beneficiaries |
127 |
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 |
59 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
147 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
19 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2557 |