| National Provider Identifier [NPI]: | 1063513588 |
| Last Name Of The Provider | WATERS |
| First Name Of The Provider | DANA |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12 WILLS WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | PISCATAWAY |
| Zip Code Of The Provider | 088543770 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 2328 |
| Number Of Medicare Beneficiaries | 375 |
| Total Submitted Charge Amount | 202269 |
| Total Medicare Allowed Amount | 133583.56 |
| Total Medicare Payment Amount | 97827.91 |
| Total Medicare Standardized Payment Amount | 85748.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 66 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 660 |
| Total Drug Medicare AllowedAmount | 376.34 |
| Total Drug Medicare PaymentAmount | 295.11 |
| Total Drug Medicare Standardized Payment Amount | 295.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 2262 |
| Number Of Medicare Beneficiaries With Medical Services | 375 |
| Total Medical Submitted Charge Amount | 201609 |
| Total Medical Medicare Allowed Amount | 133207.22 |
| Total Medical Medicare Payment Amount | 97532.8 |
| Total Medical Medicare Standardized Payment Amount | 85453.87 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 139 |
| Number Of Beneficiaries Age 75 to 84 | 125 |
| Number Of Beneficiaries Age Greater 84 | 83 |
| Number Of Female Beneficiaries | 236 |
| Number Of Male Beneficiaries | 139 |
| Number Of Non Hispanic White Beneficiaries | 284 |
| Number Of Black or African American Beneficiaries | 70 |
| 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 | 353 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4729 |