| National Provider Identifier [NPI]: | 1275536138 |
| Last Name Of The Provider | WATERHOUSE |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2478 PATTERSON RD |
| Street Address 2 Of The Provider | # 7 |
| City Of The Provider | GRAND JCT |
| Zip Code Of The Provider | 815053605 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 6344 |
| Number Of Medicare Beneficiaries | 727 |
| Total Submitted Charge Amount | 734082.4 |
| Total Medicare Allowed Amount | 613529.08 |
| Total Medicare Payment Amount | 468264.85 |
| Total Medicare Standardized Payment Amount | 461994.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1782 |
| Number Of Medicare Beneficiaries With Drug Services | 218 |
| Total Drug Submitted ChargeAmount | 133389 |
| Total Drug Medicare AllowedAmount | 117558.14 |
| Total Drug Medicare PaymentAmount | 92009.58 |
| Total Drug Medicare Standardized Payment Amount | 92009.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 4562 |
| Number Of Medicare Beneficiaries With Medical Services | 727 |
| Total Medical Submitted Charge Amount | 600693.4 |
| Total Medical Medicare Allowed Amount | 495970.94 |
| Total Medical Medicare Payment Amount | 376255.27 |
| Total Medical Medicare Standardized Payment Amount | 369984.7 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 265 |
| Number Of Beneficiaries Age 75 to 84 | 270 |
| Number Of Beneficiaries Age Greater 84 | 165 |
| Number Of Female Beneficiaries | 425 |
| Number Of Male Beneficiaries | 302 |
| Number Of Non Hispanic White Beneficiaries | 680 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 649 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 78 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| 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 | 12 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1644 |