| National Provider Identifier [NPI]: | 1801036934 |
| Last Name Of The Provider | WATSON |
| First Name Of The Provider | ANDREA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1111 RING RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ELIZABETHTOWN |
| Zip Code Of The Provider | 427014900 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 1751 |
| Number Of Medicare Beneficiaries | 301 |
| Total Submitted Charge Amount | 167530 |
| Total Medicare Allowed Amount | 103015.84 |
| Total Medicare Payment Amount | 76566.27 |
| Total Medicare Standardized Payment Amount | 82950.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 398 |
| Number Of Medicare Beneficiaries With Drug Services | 128 |
| Total Drug Submitted ChargeAmount | 11885 |
| Total Drug Medicare AllowedAmount | 5832.12 |
| Total Drug Medicare PaymentAmount | 5560.87 |
| Total Drug Medicare Standardized Payment Amount | 5560.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 1353 |
| Number Of Medicare Beneficiaries With Medical Services | 301 |
| Total Medical Submitted Charge Amount | 155645 |
| Total Medical Medicare Allowed Amount | 97183.72 |
| Total Medical Medicare Payment Amount | 71005.4 |
| Total Medical Medicare Standardized Payment Amount | 77389.57 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 86 |
| Number Of Beneficiaries Age 65 to 74 | 138 |
| Number Of Beneficiaries Age 75 to 84 | 63 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 221 |
| Number Of Male Beneficiaries | 80 |
| Number Of Non Hispanic White Beneficiaries | 251 |
| Number Of Black or African American Beneficiaries | 39 |
| 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 | 217 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 84 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0546 |