| National Provider Identifier [NPI]: | 1710971684 |
| Last Name Of The Provider | WECKSTEIN |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 TECHNOLOGY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOOKSETT |
| Zip Code Of The Provider | 031062504 |
| State Code Of The Provider | NH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 105 |
| Number Of Services | 41218 |
| Number Of Medicare Beneficiaries | 536 |
| Total Submitted Charge Amount | 2274885.55 |
| Total Medicare Allowed Amount | 1060789.52 |
| Total Medicare Payment Amount | 813657.76 |
| Total Medicare Standardized Payment Amount | 808967.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 66 |
| Number Of Drug Services | 38570 |
| Number Of Medicare Beneficiaries With Drug Services | 185 |
| Total Drug Submitted ChargeAmount | 1643170.55 |
| Total Drug Medicare AllowedAmount | 846138.97 |
| Total Drug Medicare PaymentAmount | 653714.25 |
| Total Drug Medicare Standardized Payment Amount | 653714.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 2648 |
| Number Of Medicare Beneficiaries With Medical Services | 536 |
| Total Medical Submitted Charge Amount | 631715 |
| Total Medical Medicare Allowed Amount | 214650.55 |
| Total Medical Medicare Payment Amount | 159943.51 |
| Total Medical Medicare Standardized Payment Amount | 155253.05 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 229 |
| Number Of Beneficiaries Age 75 to 84 | 184 |
| Number Of Beneficiaries Age Greater 84 | 62 |
| Number Of Female Beneficiaries | 297 |
| Number Of Male Beneficiaries | 239 |
| Number Of Non Hispanic White Beneficiaries | 513 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 481 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 55 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 58 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.9343 |