| National Provider Identifier [NPI]: | 1609958289 |
| Last Name Of The Provider | WEISS |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 360 N SEPULVEDA BLVD |
| Street Address 2 Of The Provider | SUITE 3000 |
| City Of The Provider | EL SEGUNDO |
| Zip Code Of The Provider | 902454460 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 1804 |
| Number Of Medicare Beneficiaries | 276 |
| Total Submitted Charge Amount | 210550 |
| Total Medicare Allowed Amount | 149784.04 |
| Total Medicare Payment Amount | 111135.38 |
| Total Medicare Standardized Payment Amount | 102311.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 155 |
| Number Of Medicare Beneficiaries With Drug Services | 149 |
| Total Drug Submitted ChargeAmount | 3825 |
| Total Drug Medicare AllowedAmount | 1424.91 |
| Total Drug Medicare PaymentAmount | 1394.72 |
| Total Drug Medicare Standardized Payment Amount | 1394.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 1649 |
| Number Of Medicare Beneficiaries With Medical Services | 276 |
| Total Medical Submitted Charge Amount | 206725 |
| Total Medical Medicare Allowed Amount | 148359.13 |
| Total Medical Medicare Payment Amount | 109740.66 |
| Total Medical Medicare Standardized Payment Amount | 100916.92 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 93 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | 95 |
| Number Of Female Beneficiaries | 157 |
| Number Of Male Beneficiaries | 119 |
| Number Of Non Hispanic White Beneficiaries | 230 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 263 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0348 |