| National Provider Identifier [NPI]: | 1235185620 |
| Last Name Of The Provider | DESA |
| First Name Of The Provider | WATSON |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3801 KATELLA AVE |
| Street Address 2 Of The Provider | #125 |
| City Of The Provider | LOS ALAMITOS |
| Zip Code Of The Provider | 907203338 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 2102 |
| Number Of Medicare Beneficiaries | 784 |
| Total Submitted Charge Amount | 283100 |
| Total Medicare Allowed Amount | 138256.83 |
| Total Medicare Payment Amount | 105530.8 |
| Total Medicare Standardized Payment Amount | 97047.3 |
| 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 | 41 |
| Number Of Medical Services | 2102 |
| Number Of Medicare Beneficiaries With Medical Services | 784 |
| Total Medical Submitted Charge Amount | 283100 |
| Total Medical Medicare Allowed Amount | 138256.83 |
| Total Medical Medicare Payment Amount | 105530.8 |
| Total Medical Medicare Standardized Payment Amount | 97047.3 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 198 |
| Number Of Beneficiaries Age 65 to 74 | 235 |
| Number Of Beneficiaries Age 75 to 84 | 198 |
| Number Of Beneficiaries Age Greater 84 | 153 |
| Number Of Female Beneficiaries | 416 |
| Number Of Male Beneficiaries | 368 |
| Number Of Non Hispanic White Beneficiaries | 353 |
| Number Of Black or African American Beneficiaries | 138 |
| Number Of AsianPacific Islander Beneficiaries | 93 |
| Number Of Hispanic Beneficiaries | 189 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 289 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 495 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 59 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 20 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 3.2415 |