| National Provider Identifier [NPI]: | 1841451549 |
| Last Name Of The Provider | WEIS |
| First Name Of The Provider | CHRISTINE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 ERIE CT STE 6160 |
| Street Address 2 Of The Provider | FAMILY MEDICINE CENTER |
| City Of The Provider | OAK PARK |
| Zip Code Of The Provider | 603022510 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 538 |
| Number Of Medicare Beneficiaries | 101 |
| Total Submitted Charge Amount | 45421 |
| Total Medicare Allowed Amount | 28085.83 |
| Total Medicare Payment Amount | 19997.36 |
| Total Medicare Standardized Payment Amount | 21564.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 1317 |
| Total Drug Medicare AllowedAmount | 860.32 |
| Total Drug Medicare PaymentAmount | 807.05 |
| Total Drug Medicare Standardized Payment Amount | 807.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 511 |
| Number Of Medicare Beneficiaries With Medical Services | 101 |
| Total Medical Submitted Charge Amount | 44104 |
| Total Medical Medicare Allowed Amount | 27225.51 |
| Total Medical Medicare Payment Amount | 19190.31 |
| Total Medical Medicare Standardized Payment Amount | 20757.04 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 45 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 71 |
| Number Of Male Beneficiaries | 30 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 77 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.867 |