| National Provider Identifier [NPI]: | 1801996517 |
| Last Name Of The Provider | WEAVER |
| First Name Of The Provider | JASON |
| 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 | 1602 ROCK PRAIRIE RD |
| Street Address 2 Of The Provider | SUITE 3400 |
| City Of The Provider | COLLEGE STATION |
| Zip Code Of The Provider | 778458306 |
| 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 | 72 |
| Number Of Services | 14907 |
| Number Of Medicare Beneficiaries | 1832 |
| Total Submitted Charge Amount | 1639552 |
| Total Medicare Allowed Amount | 766514.66 |
| Total Medicare Payment Amount | 552798.88 |
| Total Medicare Standardized Payment Amount | 577776.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 56 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 826 |
| Total Drug Medicare AllowedAmount | 382.26 |
| Total Drug Medicare PaymentAmount | 296.84 |
| Total Drug Medicare Standardized Payment Amount | 296.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 14851 |
| Number Of Medicare Beneficiaries With Medical Services | 1832 |
| Total Medical Submitted Charge Amount | 1638726 |
| Total Medical Medicare Allowed Amount | 766132.4 |
| Total Medical Medicare Payment Amount | 552502.04 |
| Total Medical Medicare Standardized Payment Amount | 577480.15 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 853 |
| Number Of Beneficiaries Age 75 to 84 | 722 |
| Number Of Beneficiaries Age Greater 84 | 213 |
| Number Of Female Beneficiaries | 901 |
| Number Of Male Beneficiaries | 931 |
| Number Of Non Hispanic White Beneficiaries | 1774 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1790 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.8531 |