| National Provider Identifier [NPI]: | 1437117462 |
| Last Name Of The Provider | WEISWASSER |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 230 MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | AGAWAM |
| Zip Code Of The Provider | 010011838 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 1642 |
| Number Of Medicare Beneficiaries | 390 |
| Total Submitted Charge Amount | 146725 |
| Total Medicare Allowed Amount | 77493.78 |
| Total Medicare Payment Amount | 55744.42 |
| Total Medicare Standardized Payment Amount | 55065 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 82 |
| Number Of Medicare Beneficiaries With Drug Services | 68 |
| Total Drug Submitted ChargeAmount | 3888 |
| Total Drug Medicare AllowedAmount | 2676.94 |
| Total Drug Medicare PaymentAmount | 2622.21 |
| Total Drug Medicare Standardized Payment Amount | 2622.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 1560 |
| Number Of Medicare Beneficiaries With Medical Services | 389 |
| Total Medical Submitted Charge Amount | 142837 |
| Total Medical Medicare Allowed Amount | 74816.84 |
| Total Medical Medicare Payment Amount | 53122.21 |
| Total Medical Medicare Standardized Payment Amount | 52442.79 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 137 |
| Number Of Beneficiaries Age 65 to 74 | 124 |
| Number Of Beneficiaries Age 75 to 84 | 81 |
| Number Of Beneficiaries Age Greater 84 | 48 |
| Number Of Female Beneficiaries | 227 |
| Number Of Male Beneficiaries | 163 |
| Number Of Non Hispanic White Beneficiaries | 345 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 236 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 154 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1693 |