| National Provider Identifier [NPI]: | 1669531604 |
| Last Name Of The Provider | WAUGH |
| First Name Of The Provider | WALTER |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 65 S SAINT BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | EDMOND |
| Zip Code Of The Provider | 730343051 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Sports Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 1320 |
| Number Of Medicare Beneficiaries | 156 |
| Total Submitted Charge Amount | 323425.95 |
| Total Medicare Allowed Amount | 107936.35 |
| Total Medicare Payment Amount | 83647.93 |
| Total Medicare Standardized Payment Amount | 89412.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 360 |
| Number Of Medicare Beneficiaries With Drug Services | 83 |
| Total Drug Submitted ChargeAmount | 75538.32 |
| Total Drug Medicare AllowedAmount | 27456.47 |
| Total Drug Medicare PaymentAmount | 21494.9 |
| Total Drug Medicare Standardized Payment Amount | 21494.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 960 |
| Number Of Medicare Beneficiaries With Medical Services | 156 |
| Total Medical Submitted Charge Amount | 247887.63 |
| Total Medical Medicare Allowed Amount | 80479.88 |
| Total Medical Medicare Payment Amount | 62153.03 |
| Total Medical Medicare Standardized Payment Amount | 67918.05 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 78 |
| Number Of Beneficiaries Age 75 to 84 | 50 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 103 |
| Number Of Male Beneficiaries | 53 |
| Number Of Non Hispanic White Beneficiaries | 144 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0559 |