| National Provider Identifier [NPI]: | 1083771711 |
| Last Name Of The Provider | WECKERLE |
| First Name Of The Provider | CORINNA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 25 N WINFIELD RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WINFIELD |
| Zip Code Of The Provider | 601901295 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 2165 |
| Number Of Medicare Beneficiaries | 208 |
| Total Submitted Charge Amount | 165095.32 |
| Total Medicare Allowed Amount | 77852.53 |
| Total Medicare Payment Amount | 56058.87 |
| Total Medicare Standardized Payment Amount | 52667.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1590 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 44220.32 |
| Total Drug Medicare AllowedAmount | 15772.24 |
| Total Drug Medicare PaymentAmount | 12363.3 |
| Total Drug Medicare Standardized Payment Amount | 12363.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 575 |
| Number Of Medicare Beneficiaries With Medical Services | 207 |
| Total Medical Submitted Charge Amount | 120875 |
| Total Medical Medicare Allowed Amount | 62080.29 |
| Total Medical Medicare Payment Amount | 43695.57 |
| Total Medical Medicare Standardized Payment Amount | 40304.55 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 98 |
| Number Of Beneficiaries Age 75 to 84 | 61 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 151 |
| Number Of Male Beneficiaries | 57 |
| Number Of Non Hispanic White Beneficiaries | 177 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 178 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 20 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3436 |