| National Provider Identifier [NPI]: | 1083601009 |
| Last Name Of The Provider | WEAVER |
| First Name Of The Provider | BENJAMIN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2081 N WEBB RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WICHITA |
| Zip Code Of The Provider | 672063411 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 6633 |
| Number Of Medicare Beneficiaries | 835 |
| Total Submitted Charge Amount | 576190 |
| Total Medicare Allowed Amount | 355902.72 |
| Total Medicare Payment Amount | 256111.59 |
| Total Medicare Standardized Payment Amount | 275471.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 417 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 5679 |
| Total Drug Medicare AllowedAmount | 3144.72 |
| Total Drug Medicare PaymentAmount | 2447.9 |
| Total Drug Medicare Standardized Payment Amount | 2447.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 6216 |
| Number Of Medicare Beneficiaries With Medical Services | 835 |
| Total Medical Submitted Charge Amount | 570511 |
| Total Medical Medicare Allowed Amount | 352758 |
| Total Medical Medicare Payment Amount | 253663.69 |
| Total Medical Medicare Standardized Payment Amount | 273023.53 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 106 |
| Number Of Beneficiaries Age 65 to 74 | 258 |
| Number Of Beneficiaries Age 75 to 84 | 294 |
| Number Of Beneficiaries Age Greater 84 | 177 |
| Number Of Female Beneficiaries | 471 |
| Number Of Male Beneficiaries | 364 |
| Number Of Non Hispanic White Beneficiaries | 712 |
| Number Of Black or African American Beneficiaries | 88 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 631 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 204 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6454 |