| National Provider Identifier [NPI]: | 1154402469 |
| Last Name Of The Provider | WEINSTOCK |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4845 KNIGHTSBRIDGE BLVD |
| Street Address 2 Of The Provider | SUITE 220 |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 432142463 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 442 |
| Number Of Medicare Beneficiaries | 143 |
| Total Submitted Charge Amount | 41620.39 |
| Total Medicare Allowed Amount | 29492.97 |
| Total Medicare Payment Amount | 21228.46 |
| Total Medicare Standardized Payment Amount | 22200.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 53 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 2488.5 |
| Total Drug Medicare AllowedAmount | 1632.51 |
| Total Drug Medicare PaymentAmount | 1591.95 |
| Total Drug Medicare Standardized Payment Amount | 1591.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 389 |
| Number Of Medicare Beneficiaries With Medical Services | 143 |
| Total Medical Submitted Charge Amount | 39131.89 |
| Total Medical Medicare Allowed Amount | 27860.46 |
| Total Medical Medicare Payment Amount | 19636.51 |
| Total Medical Medicare Standardized Payment Amount | 20608.14 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 60 |
| Number Of Beneficiaries Age 75 to 84 | 23 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 85 |
| Number Of Male Beneficiaries | 58 |
| Number Of Non Hispanic White Beneficiaries | 125 |
| 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 | 105 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9757 |