| National Provider Identifier [NPI]: | 1871655902 |
| Last Name Of The Provider | WEISBERG |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4685 ELDORADO PARKWAY |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | FRISCO |
| Zip Code Of The Provider | 75034 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 5687 |
| Number Of Medicare Beneficiaries | 888 |
| Total Submitted Charge Amount | 421315.4 |
| Total Medicare Allowed Amount | 352589.77 |
| Total Medicare Payment Amount | 256508.6 |
| Total Medicare Standardized Payment Amount | 270190.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 123 |
| Number Of Medicare Beneficiaries With Drug Services | 69 |
| Total Drug Submitted ChargeAmount | 12401.84 |
| Total Drug Medicare AllowedAmount | 10776.15 |
| Total Drug Medicare PaymentAmount | 7608.59 |
| Total Drug Medicare Standardized Payment Amount | 7608.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 5564 |
| Number Of Medicare Beneficiaries With Medical Services | 888 |
| Total Medical Submitted Charge Amount | 408913.56 |
| Total Medical Medicare Allowed Amount | 341813.62 |
| Total Medical Medicare Payment Amount | 248900.01 |
| Total Medical Medicare Standardized Payment Amount | 262581.42 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 552 |
| Number Of Beneficiaries Age 75 to 84 | 214 |
| Number Of Beneficiaries Age Greater 84 | 63 |
| Number Of Female Beneficiaries | 448 |
| Number Of Male Beneficiaries | 440 |
| Number Of Non Hispanic White Beneficiaries | 826 |
| Number Of Black or African American Beneficiaries | 11 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 858 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8807 |