| National Provider Identifier [NPI]: | 1861453284 |
| Last Name Of The Provider | WATHEN |
| First Name Of The Provider | GEORGE |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD PA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11345 PEMBROOKE SQ |
| Street Address 2 Of The Provider | SUITE 103 |
| City Of The Provider | WALDORF |
| Zip Code Of The Provider | 206034804 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 4894 |
| Number Of Medicare Beneficiaries | 907 |
| Total Submitted Charge Amount | 400824 |
| Total Medicare Allowed Amount | 229317.52 |
| Total Medicare Payment Amount | 168940.85 |
| Total Medicare Standardized Payment Amount | 168702.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 876 |
| Number Of Medicare Beneficiaries With Drug Services | 437 |
| Total Drug Submitted ChargeAmount | 35480 |
| Total Drug Medicare AllowedAmount | 8381.74 |
| Total Drug Medicare PaymentAmount | 7554.79 |
| Total Drug Medicare Standardized Payment Amount | 7554.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 4018 |
| Number Of Medicare Beneficiaries With Medical Services | 906 |
| Total Medical Submitted Charge Amount | 365344 |
| Total Medical Medicare Allowed Amount | 220935.78 |
| Total Medical Medicare Payment Amount | 161386.06 |
| Total Medical Medicare Standardized Payment Amount | 161147.35 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 131 |
| Number Of Beneficiaries Age 65 to 74 | 376 |
| Number Of Beneficiaries Age 75 to 84 | 253 |
| Number Of Beneficiaries Age Greater 84 | 147 |
| Number Of Female Beneficiaries | 516 |
| Number Of Male Beneficiaries | 391 |
| Number Of Non Hispanic White Beneficiaries | 703 |
| Number Of Black or African American Beneficiaries | 174 |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 736 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 171 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1436 |